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Implantoprotetika jedna je od najbrže rastućih grana u dentalnoj medicini. Pruža veliki raspon rješenja djelomične ili potpune bezubosti i uspostavlja narušenu ravnotežu u stomatognatom sustavu. Ovisno o stanju organizma, stanju usne šupljine, dobi i financijskoj mogućnosti pacijenta te znanju i educiranosti doktora dentalne medicine i kompetencijama i mogućnostima zubotehničkog laboratorija u grani implantoprotetike, odlučuje se o vrstama i načinu rehabilitacije. Svaka stomatološka protetska terapija sastoji se od poboljšanja estetskog izgleda, uspostavljanja ponovne ravnoteže okluzije, žvačnih i fonetskih funkcija kao i psihosocijalnog segmenta u životu pacijenta. Dugotrajna djelomična i potpuna bezubost imaju presudne posljedice od kojih je u usnoj šupljini najizraženija atrofija i resorpcija alveolarne kosti što je donedavno predstavljalo veliko ograničenje u izboru terapijskih postupaka. Razvojem implantoloških tehnika i samih implantata omogućena je nadoknada izgubljenih zuba bez brušenja preostalih zuba te umanjivanje resorpcije kosti i poremećaja u izgledu i funkciji mekih tkiva vezanih uz zub. Važna je odluka za kliničara nakon postavljanja dijagnoze, opće medicinske te dentalne anamneze odabir implantološkog sustava, načina retencije nadogradnje i suprastrukture kao i sam plan protetske rehabilitacije u konačnici. Svrha je ovoga rada predstaviti suvremene spoznaje u implantoprotetici kroz čimbenike kao što je izbor komponenata i opsega implantoprotetske terapije ovisno o dobi, spolu i socioekonomskom statusu pacijenta. Implant prosthetic is one of the fastest growing branches in dental medicine. It provides a wide range of solutions in partial or total anodontia where the main goal is to restore the disturbed balance of the stomatognathic system. The type and method of rehabilitation is being decided depending on the state of the organism and oral cavity, the patient’s age and financial ability, as well as the knowledge and education of the doctor of dental medicine in the field of implant prosthetics. Every prosthetic therapy consists of improving the aesthetic appearance, rebalancing the occlusion, masticatory, and phonetic functions as well as the psychosocial segment in the patient’s life. Long­term partial and total anodontia have dramatic consequences, manifested by extensive alveolar bone atrophy, which, until recently, has represented a limitation in therapy. The development of implants made it possible to compensate for lost teeth without grinding the remaining teeth and to prevent bone resorption due to the tooth loss. After the general medical and dental anamnesis, an important decision for the clinician is the selection of the implantology system, the retention method of the extension and suprastructure, as well as, ultimately, the selection of the prosthetic construction. The purpose of the paper is to present contemporary findings in implant prosthetics through factors such as the choice of prosthetic therapy depending on age, gender, and socioeconomic status.

Digitalni protokol i digitalni tijek rada postaju prijeko potrebna obveza, a ne više iznimka u modernoj dentalnoj medicini. Njihovo korištenje omogućeno je razvojem digitalne tehnologije koja je iz godine u godinu sve brža, toliko da ju se ponekad ne može u potpunosti pratiti. Korištenje analognih metoda sve se više napušta zbog nedostataka koje donosi, a koji se mogu uspješno prevladati uporabom digitalnih metoda. Još uvijek ne postoji standardizacija protokola u digitalnoj dentalnoj medicini. Cilj ovog rada bio je pokazati mogućnost oralne rehabilitacije u fiksnoj protetici na kliničkom primjeru, korištenjem jednog od mogućih digitalnih protokola, koji u potpunosti vraća funkciju i estetiku orofacijalnog sustava pacijenta na brži, predvidljiviji i precizniji način nego što je to moguće korištenjem konvencionalnih tehnika. Digital protocol and digital workflow are becoming a much­needed obligation and no longer an exception in modern dental medicine. Their use is made possible by the development of digital technology, which is getting faster every year, to the extent that sometimes we cannot fully follow its development. The use of analogue methods is increasingly abandoned due to the disadvantages it provides, which can be successfully overcome by using digital methods. Protocol standardization in digital dental medicine still does not exist. The goal of our work was to show, based on a clinical example and with the use of one of the possible digital protocols, the possibilities of oral rehabilitation in fixed prosthetics which completely restores the function and aesthetics of the patient's orofacial system in a faster, more predictable and more precise way than that is possible using conventional techniques.

Ciljevi: Cilj ovog istraživanja bio je procijeniti kvalitetu života i subjektivni osjećaj zdravlja u osoba s djelomičnom ili potpunom bezubošću. Materijali i metode: U istraživanju je sudjelovalo 34 ispitanika, pacijenta koji su došli u ambulantu za stomatološku protetiku Stomatološke poliklinike u Splitu zbog izrade nove potpune proteze. Nakon kliničkog stomatološkog pregleda ispitanici su ispunili anketni upitnik o kvaliteti života (engl. 36-Item Short Form Health Survey, SF-36) koji mjeri subjektivni osjećaj zdravlja kroz osam domena, upitnik za procjenu kvalitete života ovisne o oralnom zdravlju (engl. Oral Health Impact Profile, OHIP-14) te vizualno-analognu ljestvicu (VAS) za procjenu zadovoljstva starom potpunom protezom. Rezultati: Od 34 ispitanika koji su sudjelovali u istraživanju bilo je 26 žena (76.5%) i 8 muškaraca (23.5%), prosječne dobi 70.6±9.4 godina. Potpuno bezubih je bilo 18 ispitanika (52.9%), a 16 (47.1%) djelomično bezubih. Potpunu protezu je ranije koristilo 30 (88.2%) ispitanika, djelomičnu protezu 11 (32.4%), a fiksnoprotetski rad jedan ispitanik (2.9%). Ispitanici koji su ranije koristili potpunu protezu ocijenili su svoje zadovoljstvo protezom s 57.5±32.0 mm na VAS ljestvici. Rezultati subjektivne procjene zdravlja prema SF-36 upitniku pokazali su najlošije rezultate u kategoriji Vitalnost (55.8±16.1 bodova), a najbolje u kategoriji Psihičko zdravlje (89.9±22.7 bodova). Ukupni zbroj bodova OHIP-14 upitnika bio je 17.2±12.5 bodova (od mogućih 56 bodova). Nije bilo statistički značajne razlike između ispitanika s potpunom i djelomičnom bezubošću. Zaključak: Ovo istraživanje pokazalo je kako ispitanici s potpunom ili djelomičnom bezubošću imaju smanjenu kvalitetu života, kao i subjektivni osjećaj zdravlja. Stoga je oralna rehabilitacija uz izradu protetskog nadomjestka nužna za postizanje bolje kvalitete života u takvih osoba., Objectives: The aim of this study was to assess health related quality of life and subjective feeling of health in partially or completely edentulous individuals. Materials and methods: There were 34 participants included in the study, who attended the Department of Prosthodontics in the Dental Clinic Split, Croatia for new complete dentures fabrication. Following the clinical examination, participants completed a quality of life questionnaire, the 36-Item Short Form Health Survey (SF-36), measuring subjective feeling of health through eight health domaines, oral health related quality of life questionnaire (OHIP-14) and visual-analogue scale (VAS) to assess patient satisfaction with the previous complete dentures. Results: Out of 34 participants in this study, there were 26 female (76.5%) and 8 male (23.5%), with the mean age 70.6±9.4 years. There were 18 (52.9%) completelly edentulous and 16 (47.1%) partially edentulous participants. Complete denture was previously used by 30 (88.2%) participants, partial denture by 11 (32.4%) and fixed prosthetic restorations by one (2.9%) participant. Participants previously using complete dentures estimated their satisfaction on VAS scale with 57.5±32.0 mm. Results of the health related quality of life assessed by SF-36 questionnaire showed lowest results in the Energy and vitality domaine (55.8±16.1 points), while the highest score was reached in the Mental health domaine (89.9±22.7 points). Total sum of OHIP-14 score was 17.2±12.5 points (out of maximal 56 points), with no statistically significant differences between completelly and partialy edentulous participants. Conclusion: This study showed that completelly or partialy edentulous individuals presented reduced quality of life, as well as subjective feeling of health. Therefore, oral rehabilitation including fabrication of prosthetic restorations is necessary to improve their quality of life.

Ciljevi: Cilj ovog istraživanja bio je procijeniti kvalitetu života i subjektivni osjećaj zdravlja te kvalitetu života ovisnu o oralnom zdravlju u osoba s poremećajima temporomandibularnog zgloba. Materijali i metode: U istraživanju je sudjelovalo 34 ispitanika, kojima je u ambulanti za stomatološku protetiku Stomatološke poliklinike u Splitu dijagnosticiran poremećaj temporomandibularnog zgloba (TMP). Nakon kliničkog stomatološkog pregleda ispitanici su ispunili anketni upitnik o kvaliteti života (engl. 36-Item Short Form Health Survey, SF-36) koji mjeri subjektivni osjećaj zdravlja kroz osam domena / kategorija zdravlja (tjelesno funkcioniranje, ograničenja u ostvarivanju životnih uloga zbog tjelesnih poteškoća, ograničenja u ostvarivanju životnih uloga zbog emocionalnih problema, društveno funkcioniranje, psihičko zdravlje, vitalnost, tjelesni bolovi, percepcija općeg zdravlja), upitnik za procjenu kvalitete života ovisne o oralnom zdravlju (engl. Oral Health Impact Profile, OHIP) te vizualno-analognu ljestvicu (VAS) za procjenu boli. Rezultati: Od 34 ispitanika koji su sudjelovali u istraživanju bilo je 29 žena (85.3%) i 5 muškaraca (14.7%), prosječne dobi 38.2±15.4 godina. Neki od simptoma TMP-a (bol, ograničeno otvaranje usta, škljocanje, devijacija mandibule prilikom otvaranja usta, glavobolja, brusne fasete) imali su 33 ispitanika (97.1%), a bol su na VAS ljestvici procijenili s 61.2±21.8 mm od ukupno mogućih 100 mm. Žene su procijenile bol kao značajno jaču nego muškarci (žene 64.4±20.9 mm vs. muškarci 43.0±22.3 mm, P=0.034). Rezultati subjektivne procjene zdravlja prema SF-36 upitniku pokazali su najlošije rezultate u kategoriji Tjelesni bolovi (37.3±20.6 bodova), a najbolje u kategoriji Tjelesno funkcioniranje (78.9±22.6 bodova). Ukupni zbroj bodova OHIP-14 upitnika bio je 28.4±13.6 bodova (od mogućih 56 bodova). Nije bilo statistički značajne razlike između žena i muškaraca u rezultatima SF-36 niti OHIP-14 upitnika. Zaključci: Ovo istraživanje potvrdilo je rezultate prethodnih, kako ispitanici s TPM-om imaju smanjenu kvalitetu života, kao i subjektivni osjećaj zdravlja. Stoga je odgovarajuće liječenje ovisno o uzrocima i simptomima poremećaja važno za postizanje bolje kvalitete život u takvih osoba., Objectives: The aim of this study was to assess health related quality of life in individuals suffering from temporomandibular disorders (TMD). Materials and methods: There were 34 participants included in the study, who were diagnosed with TMD at the Department of Prosthodontics in the Dental Clinic Split, Croatia. Following the clinical examination, participants completed a quality of life questionnaire, the 36-Item Short Form Health Survey (SF-36), measuring subjective feeling of health through eight health domaines, oral health related quality of life (OHIP-14) and visual-analogue scale (VAS) to assess patient's pain caused by the TMD. Results: Out of 34 participants in this study, there were 29 female (85.3%) and 5 male (14.7%), mean age 38.2±15.4 years. Symptoms of TMD (pain, limited range of jaw opening, temporomandibular joint noises, jaw movement asymmetry, headache, bruxism) were experienced by 33 participants (97.1%), who rated pain on VAS scale with 61.2±21.8 mm. Female rated the pain as significantly stronger than male (female 64.4±20.9 mm vs. male 43.0±22.3 mm, P=0.034). Results of the health related quality of life assessed by SF-36 showed the highest score in the Physical functioning domaine(78.9±22.6 points), while the lowest score was presented in the Pain domaine (37.3±20.6 points). Total sum of OHIP-14 score was 28.4±13.6 points (out of maximal 56 points). There were no statistically significant differences in the results of SF-36 nor OHIP-14 between female and male participants. Conclusion: This showed that individuals suffering from TMD had reduced quality of life, as well as subjective feeling of health. Therefore, appropriate diagnostic and treatment procedures are necessary to improve their quality of life.

Postizanje zadovoljavajuće estetike i zdravlja potpornih tkiva zuba ključ je uspješne protetske terapije. Konvencionalne horizontalne metode preparacije zuba sa stepenicom mogu rezultirati komplikacijama u obliku upale parodonta i apikalne migracije gingive. Kao rješenje za ovu problematiku, razvijena je biološki orijentirana tehnika preparacije zuba sa ciljem postizanja boljih rezultata u vidu estetike i parodontnog zdravlja. BOPT tehnika uključuje repozicioniranje caklinsko-cementnog spojišta u odnosu na protetski nadomjestak putem privremenih krunica, omogućujući upravljanje konturom zuba i poticanje maturacije gingivalnog tkiva iz krvnog ugruška koji se formira tijekom brušenja zuba. Ova se tehnika razlikuje od konvencionalnih jer se naglasak stavlja na postizanje odgovarajuće konture gingive na nekirurški način putem kontrolirane invazije gingivnog sulkusa. Achieving good aesthetics and the health of supporting dental tissues is the key to successful prosthodontic therapy. Conventional, horizontal methods of tooth preparation with a bevel often result in complications such as periodontal inflammation and apical migration of the gingiva. As a solution to this issue, a biologically oriented preparation technique has been developed with the aim of achieving better results in terms of aesthetics and periodontal health. The Biologically Oriented Preparation Technique (BOPT) involves repositioning the enamel-cement junction in relation to the prosthetic restoration using temporary crowns. It allows the management of dental contour and promotes the maturation of gingival tissue from the blood clot formed during tooth preparation. This technique differs from conventional ones because it emphasizes achieving appropriate gingival contour, but non-surgically through controlled invasion of the gingival sulcus.

Temporomandibularni poremećaji (TMP) naziv je za patofiziološka stanja koja zahvaćaju temporomandibularne zglobove (TMZ), žvačne mišiće ili oboje. U liječenju TMP-a, kao i bruksizma, indicirana je primjena okluzijskih udlaga. Okluzijske udlage su mobilna terapijska sredstva izrađena iz akrilata, čiji je cilj postići stabilan položaj TMZ-a te ukloniti simptome i osjećaj boli. U njihovoj izradi koriste se konvencionalne metode, no razvoj tehnologije omogućuje i digitalizaciju procesa. Uporabom intraoralnih skenera, CAD/CAM sustava te 3D ispisa pojednostavljena je pohrana i prijenos podataka, kao i komunikacija s pacijentom i dentalnim laboratorijem. Smanjuju se pogreške u izradi, broj faza rada i utrošak vremena. Međutim, iako su prednosti digitalnog procesa izrade okluzijske udlage očite, većina terapeuta još se uvijek odlučuje za tradicionalni pristup izradi zbog skupoće ulaganja u digitalnu opremu. U budućnosti je cilj znanstvenim studijama dalje isticati potencijal i prednosti digitalnih tehnologija i potaknuti njihovu sve veću primjenu u svakodnevnoj stomatološkoj praksi. Temporomandibular disorders (TMD) comprise pathophysiological conditions affecting temporomandibular joints (TMJ), masticatory muscles or both. In the treatment of TMP, as well as bruxism, the use of occlusive splints is indicated. Occlusive splints are mobile therapeutic devices made of acrylic resin, the purpose of which is to achieve a stable position of the TMJ and to remove symptoms and pain. They are fabricated by using conventional methods, but technological development also enables digitization of the process. The use of intraoral scanners, CAD/CAM systems and 3D printing simplifies data storage and transfer, as well as communication with patients and the dental laboratories. Manufacturing errors, the number of working steps and time consumption are reduced. However, although the advantages of the digital process of occlusal splint fabrication are evident, most operators still opt for the traditional fabrication approach due to the high cost of investing in digital equipment. In the future, the goal of scientific studies is to further emphasize the potential and advantages of digital technologies and encourage their increasing application in everyday dental practice.

U ovo istraživanje nastojalo se uključiti što veći broj ispitanika kako bi rezultati mogli poslužiti kao dobar pokazatelj stavova studenata dentalne medicine prema korištenju digitalnih tehnologija u struci. U istraživanje je uključeno 199 ispitanika i podijeljeni su s obzirom na spol (44 muška; 22,1%, 155 ženskih; 77,9%), razinu edukacije (64 pretkliničke – 32,2%, 135 kliničke nastave – 67,8%) i mjesto studiranja (141 Stomatološki fakultet Sveučilišta u Zagrebu – 70,9%, 58 MEFST , Dentalna medicina – 29,1%). Ispitanici su većinom bili bolje upućeni u konvencionalnu tehniku otiskivanja, a o digitalnoj su se izjasnili kao ni upućeni ni neupućeni. Digitalnu tehniku otiskivanja percipiraju kao lakšu od konvencionalne. Kao najveću prednost digitalnog skeniranja ističu kraće vrijeme potrebno za uzimanje otiska (p

The usage of cements in dentistry has been prevalent for decades in various fields of the profession. Although conventional cementation has been deeply ingrained in everyday practices, it is not the best solution for all cases. Due to this, modern dentistry takes a step further by introducing adhesive cementation. It has mostly found its place in minimally invasive procedures such as veneers, since it is the only modality which specifically requires this type of cementation. The use of adhesive cementation expanded to inlays, onlays, overlays and crowns of all types of restorative materials, such as ceramics and composite. To achieve adhesion, two different substrates need to be brought close enough to form an intermolecular bond. The resin cement adheres to these two materials, and it will determine the quality of the bond. If each stage in the adhesive cementation protocol is carefully and thoroughly carried out, a satisfactory outcome can be achieved. Both the abutment and the fixed prosthodontic restoration undergo a series of preparations in the form of etching and silanization of the restoration, followed by etching and applying an appropriate adhesive to the tooth. The purpose of this thesis is to clarify the step-by-step procedure of adhesive cementation, its theoretical base involving the materials, guidelines, advantages, and disadvantages. Upotreba cementa u stomatologiji proteže se desetljećima u raznim područjima struke. Iako konvencionalna cementacija ima duboko postavljene korijene u svakodnevnoj praksi, nije najbolje rješenje za sve slučajeve. Stoga moderna stomatologija ide korak dalje uvođenjem adhezivnog cementiranja. Većinom se koristi u minimalno invazivnim postupcima poput ljuskica jer je to jedina modalnost koja specifično zahtijeva ovakvu vrstu cementiranja. Upotreba adhezivne cementacije proširila se na inleje, onleje, overleje i krunice svih vrsta restaurativnih materijala poput keramike i kompozita. Da bi se postigla adhezija, potrebno je dovesti dva različita supstrata dovoljno blizu da formiraju međumolekularnu vezu. Smolasti cement prianja na ova dva materijala i određuje kvalitetu veze. Ako se svaka faza protokola adhezivnog cementiranja pažljivo i temeljito provede, može se postići zadovoljavajući rezultat. Bataljak te fiksno protetski nadomjestak prolaze kroz niz priprema u obliku jetkanja i silanizacije nadomjestka, zatim jetkanja i nanošenja odgovarajućeg adheziva na zub. Svrha ovog diplomskog rada je razjasniti postupak adhezivnog cementiranja korak po korak, teorijsku osnovu koja uključuje materijale, smjernice, prednosti i nedostatke.

Otisni su postupci sastavni dio protetske opskrbe pacijenata. Budući da preciznost protetskog rada počiva na preciznosti radnog modela, važno je razumjeti faktore koji utječu na uspjeh otisnog postupka. Otisni materijali posjeduju različita svojstva poput preciznosti, elastičnosti, dimenzijske stabilnosti, hidrofilnosti i drugih. Dijele se na elastične i neelastične otisne materijale. Danas u upotrebi dominiraju elastični materijali koji se dodatno dijele na hidrokoloide i sintetičke elastomere. Od hidrokoloida najčešće korišten materijal je alginat, dok se od sintetičkih elastomera uporabom ističu polivinilsiloksani i polieteri. Svaka od ovih vrsta otisnih materijala pokazuje određene prednosti i nedostatke, no indikacije za njihovu uporabu obuhvaćaju gotovo sve kliničke situacije. Suvremeno doba u dentalnu je medicinu dovelo i novi način registracije intraoralnog stanja uporabom intraoralnog skenera. Stvaranjem velikog broja preklapajućih slika, intraoralni skeneri softverskom obradom trodimenzionalno reproduciraju skeniranu regiju. Unatoč brzini, ugodnosti i preciznosti, visoka cijena predstavlja barijeru za njihovu širu primjenu. Općenito smatra se da su polivinilsiloksani i polieteri zbog izvrsnih svojstava materijali izbora za izradu visokopreciznih radnih modela, dok se alginati koriste u situacijama kada visoka preciznost nije imperativ. Ipak, digitalnom analizom dimenzijskih i površinskih svojstava ovih triju skupina materijala nije dokazana smanjena vrijednost alginata u odnosu na polivinilsiloksan i polieter. Stoga se, iako su daljnja istraživanja još potrebna, postavlja pitanje upotrebljivosti alginata za izradu radnih modela. Impression procedures are an integral part of patients' prosthetic supply. Since the accuracy of prosthetic work relies on the precision of the working model, it is important to understand the factors that influence the success of the impression procedure. Impression materials possess different properties such as accuracy, elasticity, dimensional stability, hydrophilicity, and others. They are divided into elastic and non-elastic impression materials. Currently, elastic materials dominate the market and are further categorized into hydrocolloids and synthetic elastomers. The most commonly used hydrocolloid material is alginate, while polyvinylsiloxanes and polyethers stand out among synthetic elastomers. Each of these types of impression materials exhibits certain advantages and disadvantages, but their indications cover almost all clinical situations. The modern era has introduced a new way of registering intraoral conditions using intraoral scanners in dental medicine. By capturing a large number of overlapping images, intraoral scanners create a three-dimensional reproduction of the scanned region through software processing. Despite their speed, convenience, and precision, the high cost presents a barrier to their wider application. In general, polyvinylsiloxanes and polyethers are considered materials of choice for fabricating high-precision working models, while alginates are used in situations where high precision is not imperative. However, through digital analysis of the dimensional and surface properties of these three material groups, the reduced value of alginates compared to polyvinylsiloxanes and polyethers has not been proven. Therefore, although further research is still needed, the usability of alginates for making working models is being questioned.

Fiksnoprotetska terapija djece i adolescenata posebna je disciplina fiksne protetike koja se bavi restauracijom izgubljenih ili znatno oštećenih zuba fiksnim nadomjescima poput krunica, djelomičnih krunica, nadogradnji i adhezivnih odnosno privjesnih mostova. Različiti etiološki čimbenici, poput zubnog karijesa, traume, urođenog nedostatka zuba i genetskih stanja pridonose potrebi za fiksnoprotetskom terapijom u ovoj dobnoj skupini. Cilj svih fiksnoprotetskih postupaka je vratiti funkciju zuba, potaknuti pravilan rast i razvoj kraniofacijalnog kompleksa te unaprijediti samopouzdanje i dobrobit mladih pacijenata. Zbog nezavršenog rasta i razvoja te anatomskih, fizioloških i morfoloških posebnosti zuba, kao i sveukupnog orofacijalnog kompleksa djece i adolescenata, fiksnoprotetska terapija ove dobi ima određene posebnosti u usporedbi s fiksnoprotetskom terapijom u odraslih. Fixed prosthodontic therapy in children and adolescents is a special discipline of fixed prosthodontics that deals with the restoration of missing or significantly damaged teeth using fixed appliances such as crowns, partial crowns, extensions and adhesive or suspension bridges. Various etiological factors, such as dental caries, trauma, congenital lack of teeth and genetic conditions, contribute to the need of fixed prosthodontic procedures in this age group. All fixed prosthodontic procedures aim to restore tooth function, encourage proper growth and development of the craniofacial complex, and improve the self-esteem and well-being of young patients. Due to the unfinished growth and development and the anatomical, physiological and morphological peculiarities of the teeth, as well as the overall orofacial complex of children and adolescents, fixed prosthodontic therapy at this age has certain peculiarities compared to fixed prosthodontic therapy in adults.

Background and objectives: Long-term studies of clinical outcomes of mini-implants (MDIs) in the first premolar/canine sites retaining a bilateral free-ending removable partial dentures (RPD) in Kennedy class I subjects have not been well documented. The aim was to assess clinical outcomes in a prospective 5-year cohort study comparing the mandible and maxilla. Material and Methods: Participants (n = 92) who received two MDIs each and a new RPD were reviewed after one, three and five years. A total of 71 participants (82 mini-implants in the mandible; 58 in the maxilla) completed the study. Marginal bone level change, success, survival rates, Modified Plaque (MPI) and Bleeding Indices (MBI) were assessed. Results: The five-year success rate was 93.3% and 93.4% (p > 0.05), in the mandible and the maxilla, respectively. Mean peri-implant bone loss (MBL) increased significantly over five years (p < 0.01) to 0.50 mm in the mandible and 0.52 mm in the maxilla. Age had a significant effect on the MBL (higher rates in younger participants), while jaw of insertion, gender, and antagonistic jaw status did not. MPI and MBI were not significantly correlated with MBL. Conclusions: The insertion of two MDIs in previous first premolar/canine sites for retention of a free-end saddle RPD can be a successful treatment modality in subjects with narrow alveolar ridges.

Ortognatsko kirurški zahvat je rutinska praksa za ispravljanje dentoskeletnih malokluzija kod odraslih koja dovodi do boljeg dentofacijalnog sklada te poboljšanja funkcije i izgleda. Simetrični oblici lica i lijep osmjeh standard su ljepote. Osobe koje godinama trpe zbog poremećaja govora, nepravilnog zagriza i asimetrije lica često pate od kompleksa manje vrijednosti, imaju stidljiv osmjeh, zatvorene su i gube samopouzdanje. Budući da se radi o kirurškom liječenju vlastitog izbora, pacijentovo mišljenje postaje najvažnije. Tijekom samog postupka donošenja odluke, pacijent bi trebao jasno razumjeti što uključuje tretman, kao i realistične ciljeve, ostvariv ishod i trajanje liječenja. Ortognatska kirurgija jedinstven je pothvat u kirurgiji lica: pacijentov izgled i zagriz mogu se značajno poboljšati, što utječe na njegov osjećaj samopoštovanja i dobrobiti. Uspješni ishodi u modernoj ortognatskoj kirurgiji oslanjaju se na usku suradnju kirurga i ortodonta u svim fazama liječenja, od predoperativnog planiranja do završetka okluzije. Virtualno računalno planiranje potiče precizniju analizu dentofacijalnog deformiteta i predoperativnog planiranja. Također je neprocjenjiva pomoć u pružanju sveobuhvatne edukacije samoga pacijenta. Pregledom stručne i znanstvene literature svrha rada je detaljno opisati pravilan plan terapije i postupaka kod većih asimetrija lica s djelomičnom bezubošću te obuhvatiti planiranje i izvođenje ortognatsko kirurškog zahvata kao predpripremu za ugradnju implantata kod djelomične bezubosti u svrhu dugoročne stabilizacije zagriza. Orthognathic surgery is a routine practice for correcting dentoskeletal malocclusions in adults leading to better dentofacial harmony as well as improved function and appearance. Symmetrical face shapes and a beautiful smile are the standards of beauty. People who have suffered from speech disorders, abnormal bites and facial asymmetries for many years often have low self-esteem, a shy smile, are introverted or have no confidence. Since it is a surgical treatment of choice, the patient's opinion becomes the most important aspect. During the decision-making process, the patient must have a clear understanding of what the treatment involves, as well as realistic goals, achievable outcomes and duration of treatment. Orthognathic surgery is a unique endeavor in facial surgery: the patient's appearance and occlusal function can be significantly improved, affecting the patient's sense of self-esteem and well-being. Successful outcomes in modern orthognathic surgery rely on close collaboration of surgeons and orthodontists in all stages of treatment, from preoperative planning to completion. Virtual computer planning allows for more accurate analysis of dentofacial deformities and preoperative planning. It is also an invaluable assistance in providing a comprehensive education for the patient themselves. By reviewing professional and scientific literature, the purpose of this paper is to describe in detail proper treatment planning and procedures for major facial asymmetries with partial edentulism, as well as how to correctly plan and perform orthognathic surgery before implantoprosthetics.

Bruksizam je dnevna ili noćna ponavljajuća aktivnost žvačnih mišića koja uključuje škrgutanje ili stiskanje zubi i/ili guranje ili silovito potiskivanje donje čeljusti. Unatoč jasnoj definiciji, bruksizam nerijetko ostaje nedijagnosticiran, pretjerano dijagnosticiran ili pak pogrešno dijagnosticiran. Kronični je to dentalni problem s multifaktorijalnom etiologijom i bez zlatnog standarda za dijagnosticiranje i terapiju. Kliničkim pregledom mogu se utvrditi neki od znakova koji upućuju na postojanje bruksizma poput trošenja zubnog tkiva, frakture zubi ili dentalnih restauracija, hipersenzitivnosti, boli u temporomandibularnom zglobu i drugi manje specifični simptomi. Iako su istraživanja podbacila u dokazivanju izravne povezanosti gubitka površine zuba s bruksizmom, trošenje zubnih tkiva smatrano je jednim od najkarakterističnijih simptoma tog stanja. Sustav procjene trošenja zubi čiji protokol procjenjuje ozbiljnost stanja potrošenih zubnih tkiva i omogućuje raščlanjivanje patološkog od naprednog gubitka zubnog tkiva čini osnovu za daljnji terapijski plan. Budući da još ne postoji konačno terapijsko rješenje za liječenje bruksizma, svi napori usmjereni su prema prevenciji destruktivnih učinaka bruksizma od kojih je trošenje zubnog tkiva zacijelo pri vrhu. Većina takvih slučajeva mogu se uspješno liječiti preventivnim mjerama uz dugoročno praćenje i održavanje. Međutim, nedvojbeno će biti udio takvih slučajeva koji će zahtijevati restaurativnu terapiju. Bruxism is a daily or nighttime repetitive activity of masticatory muscles that refers to teeth grinding or clenching and/or pushing or forcefully pushing the lower jaw. Despite being clearly defined, bruxism often remains undiagnosed, over-diagnosed or misdiagnosed. It is a chronic dental condition of multifactorial etiology and without the gold standard for diagnosis and therapy. A clinical examination can detect some signs that point to bruxism, such as dental tissue wear, tooth fracture or dental restorations, hypersensitivity, pain in the temporomandibular joint and other less specific symptoms. Although direct link between tooth surface loss and bruxism has not yet been scientifically proven, tooth wear has been considered one of the most characteristic symptoms of the condition. The tooth wear evaluation system, whose protocol assesses how severe dental tissues have been damaged and enables the distinction between pathological and advanced tooth tissue loss, is the basis for a further treatment. Since there is still no definitive therapeutic solution for treatment of bruxism, all efforts are aimed at preventing its destructive effects, first and foremost dental tissue wear. Most such cases can be successfully treated with preventive measures including long-term monitoring and maintenance. However, there will undoubtedly be such cases that will require restorative therapy.

Uvod: Temporomandibularni poremećaji (TMD) su skupni naziv za različite simptome uzrokovane abnormalnostima u temporomandibularnom zglobu (TMZ) i povezanim strukturama. Simptomi i znakovi TMD uključuju ograničen raspon pokreta, škljocanje u funkciji i bol. Najčešće se dijagnosticira pomoću kliničkih znakova i simptoma, povezanih s psihosocijalnim i bihevioralnim statusom . TMD pogađa od 20 % do 40 % opće populacije. Cilj ovog istraživanja je ispitati učestalost temporomandibularnog poremećaja među studentima biomedicine te ispitati povezanost životnih navika i temporomandibularnog poremećaja među istima. Ispitanici i metode: Provedeno je presječno istraživanje koje je uključivalo 347 studenata Medicinskog fakulteta u Splitu. Svi ispitanici su ispunili Google Forms® anketu koja se sastojala od 74 pitanja. Anketni upitnik ispitao je sljedeće stavke; sociodemografska obilježja ispitanika, njihove životne navike, a nakon čega je usljedila procjena TMD i percepcije stresa. Rezultati: Analiza je pokazala da 42 % ispitanih studenata nema simptome TMD, kao i da 40 % pokazuju blagi TMD, dok je 12,1 % pokazalo srednji oblik, a tek 5,7 % ispitanih studenata teški oblik TMD. 77,2 % ispitanika bili su nepušači. Dok je 74 % ispitanika označilo da konzumira kavu, 80,7 % ispitanika označilo je da konzumiraju alkohol. U usporedbi s nepušačima uočena je veća učestalost srednjeg ili teškog poremećaja u ispitanika koji su pušači (P < 0,001). Ispitanici koji su konzumirali više od 2,1 šalica dnevno imali su srednje do teški TMD u usporedbi s ispitanicima koji su konzumirali 1 šalicu dnevno, P < 0,001. Pronađena je pozitivna korelacija količine stresa s ozbiljnošću TMD. Zaključak: Naše istraživanje pokazalo je da studenti biomedicinskih studija uistinu imaju povećan rizrik za temporomandibularnim poremećajem jer taj rizik pozitivno korelira s prijavljenom količinom stresa kao i životnim navikama ( konzumacija alkohola, duhanskih proizvoda, kave i energetskih pića) koje mogu pospješiti simptome TMD, Introduction: Temporomandibular disorders (TMD) are a collective name for various symptoms caused by abnormalities in the temporomandibular joint (TMJ) and related structures. Symptoms and signs of TMD include limited range of motion, clicking sounds and pain. It is most often diagnosed using clinical signs and symptoms, associated with psychosocial and behavioral status. TMD affects 20% to 40% of the general population. The aim of this research is to examine the frequency of temporomandibular disorder among biomedical students and to examine the connection between lifestyle habits and temporomandibular disorder among biomedical students. Subjects and methods: A cross-sectional survey was conducted that included 347 students of the Faculty of Medicine in Split. All respondents filled out a Google Forms® survey consisting of 74 questions. The survey questionnaire examined the following items; sociodemographic characteristics of the respondents, their lifestyle habits, followed by an assessment of TMD and stress perception. Results: The analysis showed that 42% of the examined students did not have symptoms of TMD, and that 40% showed mild TMD, while 12.1% showed a moderate form, and only 5.7% of the examined students showed a severe form of TMD. 77.2% of respondents were non-smokers. While 74% of respondents indicated that they consume coffee, 80.7% of respondents indicated that they consume alcohol. Compared to non-smokers, a higher frequency of moderate or severe disorders was observed in subjects who were smokers (p < 0.001). Subjects who consumed more than 2.1 cups per day had moderate to severe TMD compared to subjects who consumed 1 cup per day, p < 0.001. A positive correlation of the amount of stress with the severity of TMD was found. Conclusion: Our research showed that students of biomedical studies really have an increased risk for temporomandibular disorders because this risk positively correlates with the reported amount of stress as well as lifestyle habits (consumption of alcohol, tobacco products, coffee and energy drinks) that can make TMD symptoms more prominent.

Spavanje predstavlja biološki proces nužan za očuvanje zdravlja i obavljanje svakodnevnih funkcija. Doktori dentalne medicine često su prvi među zdravstvenim djelatnicima koji primijete simptome poremećaja spavanja ili im se pacijenti sami požale na njih. Stanja poput sleep apneje, bruksizma i orofacijalne boli ozbiljno narušavaju pacijentovu kvalitetu života i dovode do teških posljedica. Poremećaji spavanja zahtijevaju multidisciplinaran pristup, a veliku ulogu u ranom prepoznavanju, prevenciji i terapiji imaju doktori dentalne medicine. Pri tome je potrebno razumjeti neurobiološke mehanizme u podlozi patoloških zbivanja povezanih s poremećajima spavanja i disanja, razjasniti neuromuskularnu povezanost žvačnog sustava, prepoznati etiološke i rizične faktore te pružiti pacijentima odgovarajuću terapiju u suradnji s drugim medicinskim djelatnicima. Sleeping is a biological process essential for preserving health and carrying out everyday bodily functions. Dental practitioners are often the first health workers to detect – or hear patients complain of – symptoms of sleeping disorders. Conditions such as sleep apnea, bruxism, or orofacial pain can seriously impact a patient’s quality of life and may lead to serious complications. Treating sleep disorders requires a multidisciplinary approach in which dental practitioners play a vital role in early detection, prevention, and treatment. This demands an understanding of the neurobiological mechanisms that underlie pathological occurrences connected with sleep disorders and breathing, a clarification of the neuromuscular coherence of the masticatory system, an identification of etiological and risk factors, and the right treatment in cooperation with other medical practitioners.

Temporomandibularni poremećaji i bruksizam predstavljaju dvije najčešće indikacije za izradu okluzijskih udlaga. Okluzijsku udlagu možemo definirati kao bilo koju mobilnu, umjetnu, okluzijsku površinu koja mijenja odnos donje čeljusti prema gornjoj i upotrebljava se za dijagnostiku ili terapiju. Za izradu okluzijske udlage mogu se primijeniti konvencionalne metode: izrada postupkom kivetiranja i izrada nanošenjem akrilata na foliju. Razvojem digitalne tehnologije u stomatologiji okluzijske udlage danas se sve više izrađuju putem procesa glodanja i 3D ispisa. U potpuno digitaliziranom tijeku rada, klinički i laboratorijski postupci mogu se podijeliti u nekoliko koraka: intraoralno skeniranje i određivanje međučeljusnih odnosa, računalom potpomognuto oblikovanje (CAD – Computer Aided Design), računalom potpomognutu izradu (CAM – Computer Aided Manufacturing), završna obrada i u konačnici predaja. Prednosti primjene digitalnih tehnologija u izradi okluzijskih udlaga očituju se u bržoj izradi, uštedi materijala. Osim toga izrada je standardizirana i pouzdana, izbjegavaju se dimenzijske i druge pogreške vezane uz nesavršenost materijala. U konačnici takve udlage imaju bolji dosjed i veću ugodnost nošenja. Iako trenutna literatura ukazuje na brojne prednosti korištenja digitalne tehnologije za izradu okluzijskih udlaga, potrebne su daljnje studije visoke kvalitete i dobre metodologije kako bi se testirali i usporedili dosadašnji protokoli izrade. Temporomandibular disorders and bruxism are the two most common indications for making occlusal splints. An occlusal splint can be defined as any mobile, artificial, occlusal surface that changes the relationship of the lower jaw to the upper jaw and is used for diagnosis or therapy. In manufacturing an occlusal splint, conventional methods, such as the heat-cured method and applying acrylate to foil, can be used. With the development of digital technology in dentistry, occlusal splints are now increasingly being made through milling and 3D printing. In a fully digitalized workflow, clinical and laboratory procedures can be divided into several steps: intraoral scanning and determination of inter-jaw relationships, Computer Aided Design (CAD), Computer Aided Manufacturing (CAM), finishing and finally handover. The advantages of using digital technologies in the production of occlusion splints are manifested in faster production and material savings. Furthermore, the production is standardized and reliable while dimensional and other errors related to material imperfections are avoided. In the end, such splints have a better fit and are more comfortable to wear. Although the current literature indicates numerous advantages of using digital technology for the fabrication of occlusal splints, further studies of high quality and good methodology are needed to test and compare existing fabrication protocols.

Karijesi, traume i parodontne bolesti najčešći su uzrok potpune bezubosti. Resorpcija alveolarnog grebena proces je koji se odvija nakon gubitka zuba i dovodi do smanjenja volumena kosti, što otežava protetsku sanaciju. Smanjenim volumenom kosti pacijent gubi potrebnu koštanu potporu za retenciju i stabilizaciju konvencionalnih potpunih proteza. Ugradnja dentalnih implantata standardnih dimenzija ili mini dentalnih implantata (MDI) omogućuje adekvatnu retenciju proteze. Procjenom visine i širine kosti te gustoće kosti na CBCT snimci donosi se odluka je li pacijent kandidat za ugradnju implantata. Suvremene implantoprotetske mogućnosti za potpunu bezubost nude rješenja poput proteza retiniranih implantatima te fiksnih mostova na četiri implantata (all on 4) ili na šest implantata (all on 6). Minimalni broj implantata za retenciju pokrovne proteze u mandibuli je dva, dok je za maksilu četiri. Sustav veznih elemenata LOCATOR® ili sustav prečki najčešće se primjenjuju za povezivanje proteze s implantatima u obje čeljusti. Fiksni most na četiri implantata smatra se najboljim rješenjem za mandibulu zbog njezine veće gustoće kosti od maksile, dok fiksni most na šest implantata predstavlja najbolje rješenje za maksilu. Ako je postignuta primarna stabilnost, implantati se mogu imedijatno opteretiti privremenim protetskim radom i pacijent će odmah dobiti privremeni rad. Caries, trauma and periodontal diseases are among the most common causes of complete edentulism. Resorption of the alveolar ridge is a process that takes place after tooth loss and leads to a decrease in bone volume, which makes prosthetic rehabilitation difficult. With reduced bone volume, the patient loses the necessary bone support for the retention and stabilization of conventional complete dentures. The insertion of standard-sized dental implants of standard dimensions or mini dental implants (MDI) enables adequate retention of the prosthesis. By evaluating the height and width of the bone, as well as the bone density on the CBCT image, a decision is made whether the patient is a candidate for implant placement. Modern implant-prosthetic options for complete edentulism offer solutions such as implantretained dentures and implant-supported fixed bridges that sit on four (All-on-4) or on six implants (All-on-6). The minimum number of implants for the retention of mandibular overdenture is two, while for the retention of maxillary overdenture it is four. The LOCATOR® attachment system and the bar attachment system are frequently used to connect prostheses with implants in both jaws. A fixed bridge on four implants is considered the best solution for the mandible, due to its higher bone density than the maxilla, while a fixed bridge on six implants is the best solution for the maxilla. If primary stability is achieved, immediate implant loading can take place, and the patient will receive temporary prosthetic work momentarily.

Pitanje potpune bezubosti predstavlja složen biomehanički problem koji se standardno rješava izradom konvencionalnih potpunih proteza. One su retinirane isključivo ventilnim učinkom i često ne osiguravaju dovoljnu retenciju i stabilizaciju proteze pa rezultiraju nezadovoljstvom pacijenata žvačnom funkcijom. Danas, međutim, suvremena stomatologija nudi rješenje u obliku fiksnih ili mobilnih nadomjestaka retiniranih implantatima. Pokrovna proteza na implantatima mobilni je nadomjestak koji može nadomjestiti najveće resorpcije alveolarnog grebena, a brojna su istraživanja pokazala kako su pokrovne proteze na implantatima odličan terapijski postupak za bezube pacijente zbog znatnog poboljšanja funkcije žvakanja, retencije i stabilnosti proteza, a samim time i kvalitete života ovisne o oralnom zdravlju (OHRQoL) u odnosu na prethodno iskustvo nošenja potpunih proteza. Najčešće se za retenciju potpunih proteza ugrađuju implantati standardnih dimenzija, međutim, postoje slučajevi u kojima je alveolarni greben resorbiran u tolikoj mjeri da ne postoji adekvatna širina grebena za njihovu ugradnju. Takvi, uski grebeni na izbor ostavljaju jedino mini dentalne implantate (MDI) promjera manjega od 2.5 mm. Njihova je ugradnja minimalno invazivan postupak te su financijski prihvatljiviji od standardnih implantata. Zbog brojnih prednosti i rasta broja objavljenih kritičkih istraživanja o njihovoj upotrebi, očekuje se skorašnje proširenje interesa te preciznije definiranje indikacija i kontraindikacija za njihovu ugradnju. The issue of complete edentulism is a complex biomechanical problem that is usually solved by making conventional complete dentures. They are retained exclusively by the valve effect and often do not provide sufficient retention and stabilization of the denture, resulting in patient discontentment with chewing function. Today, however, modern dentistry offers a solution in the form of fixed or mobile restorations retained by implants. An implant-retained overdenture is a mobile replacement that can replace the largest resorptions of the alveolar ridge, and numerous studies have shown that implant-retained overdentures are an excellent therapeutic procedure for edentulous patients due to the significant improvement of chewing function, retention and stability of the prostheses, and by that also the quality of life depending on oral health (OHRQoL) in comparison to the previous experience of wearing complete dentures. Most often, implants of standard dimensions are inserted for the retention of complete dentures, however, there are cases in which the alveolar ridge is resorbed to such an extent that there is no adequate ridge width for their insertion. Such narrow ridges leave only the choice of mini dental implants (MDI) with a diameter less than 2.5 mm. Their insertion is a minimally invasive procedure and they are more financially acceptable than standard size implants. Due to the numerous advantages and the growing number of published critical studies on their use, it is expected that interest in them will soon expand and that the indications and contraindications for their insertion will be more precisely defined.

Cilj istraživanja: Glavni cilj ovog istraživanja je bio ispitati dolazi li do povećanja kvalitete života povezane s oralnim zdravljem nakon predaje novih potpunih proteza uz uporabu adheziva. Materijali i metode: U ispitivanju je sudjelovao 15 ispitanika čija se dob kretala od 56 do 83 godine. Istraživanje je provedeno korištenjem OHIP upitnika. Statistička analiza napravljena je s pomoću statističkoga paketa SPSS 12.0. (Statistical package for Social Science, Chicago, Illinois, SAD). Rezultati: U istraživanju je sudjelovalo 15 ispitanika, čija se dob kretala od 56 do 83 godina. Dokazana je statistički značajna razlika nakon predaje donje potpune proteze te nakon uporabe adheziva. Nisu dokazane statistički značajne razlike u ovisnosti o spolu i dobi. Zaključak: Rezultati ovog istraživanja pokazali su da je kvaliteta života pacijenata nositelja donjih potpunih proteza nakon primjene adheziva bolja., Objectives: The main aim of this research was to examine whether there is an increase in quality of life related to oral health after delivering new total dentures with the use of adhesives. Materials and methods: 15 subjects, whose ages ranged from 56 to 83, participated in the research. The research was conducted using the OHIP questionnaire. Statistical analysis was done using the statistical package SPSS 12.0. (Statistical package for Social Science, Chicago, Illinois, USA). Results: 15 subjects, whose ages ranged from 56 to 83, participated in the research. A statistically significant difference was shown after the delivery of the lower total denture and after the use of adhesive. No statistically significant differences were found depending on gender and age. Conclusions: The results of this study showed that the quality of life of patients who use lower total dentures is better after the application of adhesive.

Temporomandibularni poremećaji skupina su mišićno-koštanih poremećaja karakterizirana simptomima koji obuhvaćaju žvačne mišiće, temporomandibularne zglobove ili oboje. Prevalencija temporomandibularnih poremećaja je u porastu, a kod adolescenata u dobi od 10 do 19 godina kreće se u rasponu od 7,3% do 30,4%. Tako visoki postotak prevalencije treba uzeti s dozom opreza budući da su korištene različite metode procjene koje su se pokazale manjkavima. Etiologija TMP-a multifaktorijalna je i nerazjašnjena. Mnogi čimbenici poput traume, parafunkcija, psihosocijalnih poremećaja, spola, genetike itd. navode se kao mogući, no često je teško izdvojiti samo jedan kao okidač razvoja TMP-a. Od 2014. godine međunarodni standard za procjenu temporomandibularnih poremećaja je Dijagnostički kriteriji za temporomandibularne poremećaje (DK/TMP). S obzirom na rastuću prevalenciju, značajan utjecaj na život i brojne razlike između djece i adolescenata u odnosu na odraslu populaciju, javila se potreba za modifikacijom protokola kako bi se ovaj model mogao koristiti i kod osoba mlađih od 19 godina. Prilikom oblikovanja dijagnostičkog instrumenata za djecu i adolescente, ključnim se pokazalo preoblikovati usmeni i pismeni način izražavanja, klinički pregled prilagoditi dobnoj skupini te uvesti nove instrumente koji će pomoći pri psihološkoj evaluaciji pacijenta. Nedostatak standardiziranih studija o terapijskim mogućnostima djece i adolescenata s temporomandibularnim poremećajima ukazuje na potrebu za daljnjim istraživanjima. Ipak, jedna od najčešće korištenih metoda terapije za djecu i adolescente je informacija o poremećaju nakon čega slijedi fizikalna terapija. Okluzijska udlaga u dječjoj i adolescentnoj dobi predmetom je mnogih rasprava. Zbog mogućeg nepovoljnog djelovanja na rast čeljusti, promjena u okluziji, nastanka otvorenog zagriza i karijesa, prilikom ordiniranja okluzijske udlage nužne su češće kontrole te nošenje udlage samo kroz kraći vremenski period. Temporomandibular disorders are a group of musculoskeletal disorders characterized by symptoms involving masticatory muscles, temporomandibular joints, or both. The prevalence of temporomandibular disorders is increasing. In adolescents aged 10 to 19 years it ranges from 7.3% to 30.4%. Such a high percentage of prevalence should be taken with caution since different assessment methods were used which have since proved to be flawed. The etiology of TMD is multifactorial and unclear. Many factors such as trauma, parafunctions, psychosocial disorders, gender, genetics, etc. are cited as possible triggers, but it is often difficult to single out just one as the trigger for the development of TMD. Since 2014, the international standard for the assessment of temporomandibular disorders is the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Considering the growing prevalence, significant impact on life, and numerous differences between children and adolescents compared to the adult population, there was a need to modify the protocol so that this model could also be used in people under 19 years of age. When designing a diagnostic instrument for children and adolescents, it turned out to be crucial to reshape the oral and written way of expression, adapt the clinical examination to the age group, and introduce new instruments that will help in the psychological evaluation of the patient. The lack of standardized studies on therapeutic options for children and adolescents with temporomandibular disorders indicates the need for further research. However, one of the most commonly used methods of therapy for children and adolescents is information about the disorder followed by physical therapy. Using an occlusal splint in children and adolescents is a subject of many discussions. Due to the possible adverse effects on the growth of the jaw, changes in occlusion, the occurrence of open bite and caries, more frequent checks are necessary when prescribing an occlusal splint and the splint should only be worn for a shorter period of time.

Cilj: Glavni cilj ovog istraživanja bio je ispitati stavove i praksu doktora dentalne medicine o upotrebi obraznog luka u protetičkom liječenju. Specifični ciljevi istraživanja bili su ispitati iskustva doktora dentalne medicine te učestalost upotrebe obraznog luka u kliničkom radu. Materijali i metode: U razdoblju od ožujka do početka srpnja 2022. godine provedeno je presječno istraživanja s ciljem utvrđivanja stavova i prakse doktora dentalne medicine o upotrebi obraznog luka u protetičkom liječenju. Istraživanje se temeljilo na anonimnom anketnom upitniku dijeljenom putem Google obrasca. U prvom dijelu anketnog upitnika prikupljeni su opći podaci ispitanika, dok se drugi dio upitnika odnosio na stavove i praksu ispitanika u vezi s upotrebom obraznog luka. Rezultati: U istraživanju su sudjelovala 103 doktora dentalne medicine. Većina ispitanika (71 %) zadovoljna je ishodom vlastite protetičke terapije bez obzira na to koriste li obrazni luk ili ne. Čak 84 % ispitanika smatra kako nema dovoljno znanja o pravilnoj upotrebi obraznog luka, a samo 17 % ispitanika pohađalo je dodatne edukacije. Veći dio ispitanika, njih 77 %, nikada ili rijetko koristi obrazni luk u svom kliničkom radu. Kao razloge za to navode neznanje (31 %) te nedostatak opreme (39 %), unatoč većinskom mišljenju ispitanika (60 %) kako su rezultati postignuti s obraznim lukom značajno bolji. Rezultati za navedene kliničke situacije, u kojima se upotreba obraznog luka smatra indicirana, bili su poprilično loši. Pohvalna stvar za dobivene rezultate je zainteresiranost većeg broja ispitanika (86 %) za dodatne edukacije o upotrebi obraznog luka. Zaključak: Na osnovu rezultata ovog istraživanja potvrđeno je kako većina doktora dentalne medicine nema dovoljno znanja o obraznom luku, ta da njegova primjena nije učestala u svakodnevnoj kliničkoj praksi. Navedeni rezultati ukazuju na potrebu dodatnih znanstvenih istraživanja kako bi se razjasnila stvarna potreba obraznog luka u protetičkom liječenju., Objectives: The main goal of this research was to examine the attitudes and practice of Doctors of Dental Medicine regarding the use of face bow in prosthetic treatment. The specific objectives of the research were to examine the experiences of Doctors of Dental Medicine and frequency of using the face bow in clinical work. Materials and methods: In the period from March to the beginning of July 2022, a cross-sectional study was conducted with the aim of determining the attitudes and practices of doctors of dental medicine regarding the use of face bow in prosthetic treatment. The research was based on an anonymous questionnaire distributed via a Google form. In the first part, the general information of the respondents was collected, while the second part of the questionnaire refers to the attitudes and practices of the respondents in relation to the face bow. Results: Total of 103 Doctors of Dental Medicine participated in the research. The majority of respondents (71 %) are satisfied with the outcome of their own prosthetic therapy, regardless of whether they use a face bow or not. As many as 84 % of them believe that they do not have enough knowledge about the correct use off face bow, and only 17% of respondents attended additional education. Most of the respondents, 77 % of them, never or rarely use the face bow in their clinical work. The reasons for this are mostly given by ignorance (31 %) and lack of equipment (39 %), despite the majority opinion of the respondents (60 %) that the results achieved with the face bow are significantly better. The results for the mentioned clinical situations, in which the use of the face bow is considered indicated, were quite poor. The commendable thing about the obtained results is the interest of a large number of respondents in additional education on the use of face bows, as many as 86 % of them. Conclusions: Based on the results of this research, it was confirmed that most doctors of dental medicine do not have enough knowledge about the face bow, and that its application is not frequent in everyday clinical practice. The above results point to the need for additional scientific research in order to clarify the real need for face bows in prosthetic treatment.

Cilj istraživanja: Glavni cilj istraživanja je ispitati i potvrditi odnos Camperove linije i okluzijske plohe kod ozubljenih eugnatih ispitanika. Materijali i metode: U istraživanju je sudjelovalo 30 ispitanika, studenata dentalne medicine. Ispitanicima je postavljena Foxova ploha na gornje zube, zatim su fotografirani u lateralnoj projekciji. Fotografije ispitanika prebačene su u računalni program gdje je nacrtanaCamperova linija. Izmjeren je kut koji zatvaraju Camperova linija i okluzijska ploha. Analiza podataka napravljena je pomoću programa Microsoft Excel 2007. Rezultati: Prosječna apsolutna vrijednost kuta iznosi 3,67°. Utvrđeno je da ne postoji apsolutnaparalelnost između ovih dviju linija. U svim skupinama ispitanika, kod 40% ispitanika linije su zatvarale negativan kut. Postotak ispitanika čija je apsolutna vrijednost kuta iznosila do 5° je 63.33% (n=19) što se smatra optimalnim kutem. Nakon izračuna karakterističnih statističkih vrijednosti (miminum, maksimum, aritmetička sredina, standardna devijacija) i izrade grafičkog prikaza utvrđeno je da realne vrijednosti kuta imaju tendenciju normalne raspodjele po Gaussovoj krivulji. Zaključak: Ne postoji apsolutna paralelnost između Camperove linije i okluzijske plohe. Povoljan odnos ovih dviju linija ima 63,33% ispitanika. Realne vrijednosti kuta između te dvije linije imaju tendenciju normalne raspodjele po Gaussovoj krivulji., Objectives: The main goal of the study is to examine and confirm the relationship between the Camper line and the occlusal plane in the toothed eugnate subjects. Materials and methods: Thirty subjects, dental students, participated in the study. Fox's plane was placed on the upper teeth of the subjects, then photographed in a lateral projection. Photos of the subjects were transferred to a computer program where the Camper's line was drawn. The angle closed by the Camper's line and the occlusal plane was measured. Data analysis was done using Microsoft Excel 2007. Results: The average absolute value of the angle is 3,67°. It was found that there is no absolute parallelism between these two lines. In all groups of subjects, in 40% of them the lines closea negative angle. The percentage of subjects whose absolute angle value was up to 5° is 63,33% (n=19) which is considered the optimal angle. After calculating the characteristic statistical values (minimum, maximum, arithmetic mean, standard deviation) and making a grafic presentation , it was determined that the real values of the angle tend to be normally distributed according to the Gaussian curve. Conclusion: There is no absolute parallelism between the Camper's line and the occlusal plane. 63,33% of subjects have a favorable relationship between these two lines. The real angle values between the two lines have the tendency of normal distribution along the Gaussian curve.

Cilj: Cilj ovog istraživanja bio je procijeniti znanje i stavove doktora dentalne medicine u Republici Hrvatskoj o opstrukcijskoj apneji tijekom spavanja (OSA) te usporediti znanje i stavove o OSA-i između specijalista i općih doktora dentalne medicine kao i između doktora dentalne medicine koji su imali edukaciju o poremećajima spavanja tijekom studiranja i onih koji nisu. Materijali i metode: U istraživanju je sudjelovalo 143 ispitanika. Istraživanje je provedeno koristeći anketni upitnika OSAKA (engl. Obstructive Sleep Apnea Knowledge and Attitudes, OSAKA) u obliku Google Forms-a. Anketni upitnik se sastojao od tri dijela. U prvom dijelu prikupljeni su opći podaci ispitanika. U drugom dijelu sa 18 pitanja se provjeravalo znanje ispitanika o OSA-i, a u trećem dijelu s pet tvrdnji su se utvrđivali stavovi o OSA-i. Ukupno znanje doktora dentalne medicine o OSA-i (engl. Correct Knowledge Score of Obstructive Sleep Apnea, CKS-OSA) dobiveno je zbrajanjem točnih odgovora, pri čemu je svaki točni odgovor donosio 1 bod, a ukupni rezultat mogao je biti između 0 i 18 Rezultati: Ukupno znanje doktora dentalne medicine u Republici Hrvatskoj o OSA-i iznosilo je 9,15±3,78 bodova, od mogućih 18. Nije postojala statistički značajna razlika u znanju o OSA-i između doktora dentalne medicine različitih specijalnosti i općih doktora dentalne medicine u Republici Hrvatskoj. Doktori dentalne medicine koji su imali edukaciju o poremećajima spavanja tijekom studiranja pokazali su bolje znanje od onih koji takvu edukaciju nisu imali (CKS-OSA 10,61±2,61 bodova vs. 8,88±3,90 bodova, P=0,027). Zaključak: Ovo istraživanje potvrdilo je rezultate prethodnih kako je znanje doktora dentalne medicine o OSA-i nedovoljno i kako se ne osjećaju sigurno i kompetentno takve pacijente dijagnosticirati te im pružiti odgovarajući tretman. Činjenica da je znanje onih koji su imali edukaciju bolje u odnosu na one bez edukacije ukazuje na potrebu da se edukacijski programi integriraju u fakultetsku nastavu. Ipak, stavovi većine ispitanika prema OSA-i su pozitivni i svjesni su da je riječ o važnom javnozdravstvenom problemu čija je prevalencija u porastu., Objectives: The aim of this study was to assess the knowledge and attitudes about obstructive sleep apnea (OSA) among doctors of dental medicine in Croatia. Additionally, we compared the knowledge and attitudes regarding OSA between general doctors of dental medicine and specialists and between doctors of dental medicine who previously had some education about OSA and ones that did not. Material and methods: There were 143 participants included in the study. The study was conducted using the Obstructive Sleep Apnea Knowledge and Attitudes Questionnaire (OSAKA) which was distributed to the participants through Google Forms. The questionnaire consisted of three parts. The first part comprised general questions. The second part consisted of 18 questions about the knowledge regarding OSA and the third part estimated attitudes about OSA through five statements. Correct Knowledge Score of Obstructive Sleep Apnea (CKS-OSA) was calculated based on correct answers on 18 questions, while possible total score was between 0 and 18 points. Results: CKS-OSA was 9.15±3.78 points, out of a possible 18 points. There was no statistically significant difference in knowledge regarding OSA between specialists and general dental medicine doctors in Croatia. However, dental medicine doctors that had some education about sleep disorders during their studying showed statistically significant better knowledge than the ones who did not have such an education (CKS-OSA 10.61±2.61 points vs. 8.88±390 bodova, P=0.027). Most of the participants showed positive attitudes towards OSA. Conclusion: This survey comfirmed the results of the ones that were conducted before showing that the general knowledge regarding OSA among doctors of dental medicine is insufficient. Also, they do not feel confident in diagnosing and treating those patients. This fact and the one that doctors of dental medicine who previously had some education about sleep disorders showed better knowledge than the ones who did not have such education are indicating the need for introducing sleep medicine teaching in dental medicine curricula and programs. However, most of doctors had positive attitudes towards OSA which shows they are aware OSA as a big problem of public health with increasing prevalence.

Uvod: Cilj našeg istraživanja bio je otkriti kolika će biti promjena nagiba protetske plohe nakon petogodišnjeg nošenja potpune proteze. Materijali i metode: U istraživanju je sudjelovalo 20 ispitanika. Svakome od ispitanika napravljena su dva lateralna kefalograma. Prvi kod predaje proteze, a drugi nakon petogodišnjeg nošenja proteze. Snimanja su obavljena na rendgenskom aparatu (Siemens Roentgen Kugel 2E), a svi rendgen-filmovi bili su od istog proizvođača (AGFA-ORTHO CP-G PLUS), dobiveni na sličan način u istoj kutiji pomoću razvijača istog proizvođača (AGFA G 138 i). Ručnim precrtavanjem s telerendgenogramom na paus-papir s 3H crtaćom olovkom prikupljeni su kefalometrijski podaci. Sva detaljnija mjerenja rađena su uz pomoć precizne pomične mjerke (MEBA, Zagreb, Hrvatska). Statistički izračun je napravljen pomoću programa SPSS 12.0. (Statistical package for Social Science, Chicago, Illinois, USA). Rezultati: Rezultati nam ukazuju da je došlo do statistički značajnih promjena kutova protetske plohe u odnosu na mandibularnu (Me-Go), palatinalnu (ANS-PNS) i frankfurtsku horizontalu (Po- Or) tijekom petogodišnjeg nošenja proteze. Zaključak: Kod svih sudionika tijekom petogodišnjeg nošenja potpune proteze dolazi do statistički značajne promjene kuta protetske plohe. Nužna je izrada nove potpune proteze zbog narušene funkcionalnosti uslijed promjene nagiba protetske plohe., Aim: The aim of our study was to find out what the change in the slope of the prosthetic plane will be after five years of wearing a complete prosthesis. Materials and Methods: A total of 20 subjects participated in the study. Two lateral cephalograms were performed for each of the subjects, the first when the prosthesis was placed, and the second after five years of prosthesis wearing. Imaging was performed on an X-ray machine (Siemens Roentgen Kugel 2E), with all X-ray films being from the same manufacturer (AGFA-ORTHO CP- G PLUS) and obtained in a similar manner, in the same box using a developer produced by the same manufacturer (AGFA G 138 i). Cephalometric data were collected by manually tracing a teleroentgenogram on tracing paper with a 3H pencil. All detailed measurements were made using a precision sliding caliper (MEBA, Zagreb, Croatia). The statistical calculation was made using the SPSS 12.0 program (Statistical Package for Social Science, Chicago, Illinois, USA). Results: The results point to the fact that there were statistically significant changes in the angles of the prosthetic plane in relation to the mandibular (Me-Go), palatal (ANS-PNS), and Frankfurt horizontal plane (Po-Or) during the five-year-long prosthesis wearing. Conclusion: A statistically significant change in the angle of the prosthetic plane occurred in all participants during the five-year-long wearing of a complete prosthesis. New complete prostheses were required due to impaired functionality given the changes in the slope of the prosthetic surface.

Protetska rehabilitacija implantatima jedan je od najsuvremenijih načina povratka žvačne funkcije, estetike osmijeha i zadovoljstva pacijenta. Temelji dugoročno uspješne implantoprotetske terapije biološki su zdrava periimplantatna tkiva. Na njihovo ostvarivanje i oblikovanje utječe izvedba svake faze terapije, a željeni rezultat može se postići isključivo pomnim planiranjem. Prilikom kliničkog pregleda važno je odrediti biotip gingive koji predstavlja glavni prognostički čimbenik izgleda mekih tkiva završetkom terapije. Atraumatski pristup ekstrakciji zuba na mjestu postave implantata rezultira očuvanjem visine alveolarne kosti, ali i integriteta mekih tkiva. Odabir materijala, oblika tijela i strukture površine implantata, uz softverski planiran trodimenzionalni smještaj implantata u kosti, ključni su faktori uspješne oseointegracije.Estetski izgled potpornih tkiva postiže se odabirom odgovarajuće nadogradnje i privremenim nadomjeskom jer kreiranjem njihovih kontura izravno oblikujemo meka tkiva do željenog oblika – dizajniramo tzv. izlazni profil. Spoj implantata i nadogradnje, kao i spoj između nadogradnje i trajne protetske suprastrukture važni su za strukturnu i funkcijsku trajnost implantata. Krajnji rezultat terapije trebao bi biti na obostrano zadovoljstvo pacijenta i doktora dentalne medicine u vidu visoko estetskog rada koji posjeduje skladnu crveno-bijelu estetiku. Prosthetic dental implants rehabilitation is one of the most modern ways of restoring chewing function, smile aesthetics and patient satisfaction. The foundations of a long-term successful implant therapy are biologically healthy peri-implant tissues. Their realization and formation is influenced by the performance of each phase of the therapy, and the desired result can only be achieved by careful planning. During the clinical examination, it is important to determine the gingival biotype which is the main prognostic factor of soft tissues appearance at the end of therapy. Atraumatic tooth extraction at the place of implant placement results in preserving the height of alveolar bone, as well as the integrity of soft tissues. The choice of material, body shape and surface structure of the implant, along with the software-planned three-dimensional placement of the implant in the bone, are key factors of successful osseointegration. The esthetic appearance of the supporting tissues is achieved by choosing the appropriate abutment and temporary restoration because by creating their contours, we directly shape the soft tissues to the desired look - we design the so-called emergence profile. Connection between the implant and the abutment, as well as the connection between the abutment and the final prosthetic restoration are important for the structural and functional durability of the implant. The final result of therapy should be of mutual satisfaction for the patient and the dentist in the form of highly aesthetic work that has harmonious red-white aesthetics.

Današnja, suvremena stomatologija zahtijeva brza rješenja koja zadovoljavaju najviše estetske i funkcionalne standarde terapije. Izrada fiksnoprotetskog rada nošenog dentalnim implantatima kod potpuno bezubih pacijenata pripada među najsloženije kliničke slučajeve dentalne implantološke protetike. Točno postavljena indikacija nakon provedene dijagnostike,odabir protokola opterećenja dentalnih implantata te provedba kirurških, protetskih i laboratorijskih postupaka glavni su razlozi tomu. Svaka faza ovakve implantoprotetske rehabilitacije ima svoje posebnosti s konačnim ciljem terapije, a to je izrada dugoročno uspješnoga funkcionalnog i estetskog fiksnoprotetskog rada. Upravo zato potrebna je bliska suradnja oralnog kirurga / implantologa, specijalista stomatološke protetike / liječnika dentalne medicine i dentalnog tehničara koji moraju biti vrlo dobro uvježbani i sigurni u području svojeekspertize. U radu je prikazan klinički slučaj od početne situacije, tj. pacijent s uznapredovalim kroničnim parodontitisom (zbog čega je bila indicirana ekstrakcija svih zuba u obje čeljusti), nakon čega je slijedila implantoprotetska terapija potpuno bezubog pacijenta u fazama. Poslije razdoblja cijeljenja bezubih alveolarnih grebena uslijedio je kirurški postupak ugradnje dentalnih implantata (po šest implantata u bezuboj čeljusti). S obzirom na povijest bolesti pacijenta (kronični parodontitis), kvalitetu, kvantitetu i gustoću gornjega i donjega bezubog alveolarnog grebena (dijagnostika: trodimenzionalna računalna tomografija – procjena kosti nakon razdoblja cijeljenja), bila je donesena kirurška indikacija o odabiru konvencionalnog protokola opterećenja dentalnih implantata (fiksni protetski rad izrađen je nakon razdoblja oseointegracije od šest mjeseci). U drugoj protetskoj fazi terapije prikazani su klinički i laboratorijski postupci izrade fiksnoga protetskog rada retiniranog vijcima na tzv. multi-unit nadogradnjama koje su bile fiksirane vijcima u dentalnim implantatima. Opskrba bezubog pacijenta većim brojem implantata sigurnije je rješenje i pruža veće mogućnosti kod odabira vrste rada i protetskog materijala od kojega će se napraviti fiksni protetski rad. Protetski radovi na vijak općenito izazivaju manje bioloških komplikacija u vidu pojavnosti periimplantitisa koji je učestaliji kod fiksnih radova koji se cementiraju na nadogradnjama. Kod fiksnih radova na vijak najvažnije je osigurati pasivan dosjed (test Sheffield) na nadogradnjama te izbacitisvaku mogućnost stvaranja naprezanja u području spoja dentalnog implantata i protetskog rada. Izbor protetskih materijala za fiksne radove nošene dentalnim implantatima također je širok, a on uglavnom ovisi o točno postavljenoj indikaciji za ovakav oblik terapije bezubog pacijenta, o znanju, vještini i iskustvu kliničara i zubnog tehničara te o opremljenosti zubotehničkog laboratorija. U svakom slučaju, protetski materijali poput metalokeramike ili suvremeniji materijali poput cirkonij-dioksidne potpune keramike pokazali su se u svakodnevnoj praksi i objavljenim znanstvenim studijama vrlo standardnim i pouzdanim materijalima koji zadovoljavaju dugoročne estetske, biomehaničke i funkcionalne zahtjeve fiksnih radova nošenih dentalnim implantatima kod potpuno bezubog pacijenta. Modern dentistry demands therapeutic solutions that are fast and, at the same time, have highest aesthetic and functional standards satisfied. Full mouth rehabilitation of completely edentulous patients with fixed prosthetic restoration can easily be classified as one of the most complicated cases in dental implantology. Reasons for this claim are that, for this kind of rehabilitation to be successful, a lot of steps must be set correctly. Firstly, correct indication must be set, then protocol for dental implant loading followed with correct implementation of surgical, and in the end, prosthetic, and laboratory procedures. Every step of this kind of rehabilitation has its own specifics, but long-term aesthetic and functional success of prosthetic therapy always is the main goal. Having said that, close cooperation must be between oralsurgeon/implantologist,prosthetic specialist and dental technician and they need to be reliable in they part of this procedure. In this article a clinical case is being described from starting situation where patient was diagnosed with advanced chronical periodontitis (because of that diagnose extraction of all teeth was indicated), and in second part where, through phases, is described how patient is rehabilitated, first with dental implants, and then with screw-retained fixed prosthetic restoration supported by dental implants. Firstly, teeth were extracted and then, after healing period, patient undergone surgery where he got six dental implants, per edentulous jaw. Considering few parameters, such as history of dental periodontitis, quality, quantity and density of bone in both jaws (diagnosed with three-dimensional computed tomography- post extraction bone healing), decision was that implant loading would be conventional, which means that they will be loaded with fixed prosthetic restoration, after six months. In second, prosthetic therapy phase, both clinical and laboratory procedures in the making of fixed, screwretained prosthetic restoration are being described. Providing a patient with larger number of implants is a safer therapy plan but besides that, it gives doctor and technician more options to choose between various types of therapy plans and prosthetic materials. Screw-retained fixed prosthetic restorations show much fewer biological complications (periimplantitis) then cemented ones. In these kinds of prosthetic solutions, frameworks need to be passive when put on multi-unit abutments (Sheffield test), without making any tensions in dental implant – prosthetic restoration/framework interface. There is a wide selection of prosthetic materials that can be used for fixed prosthetic restorations on dental implants. Which one is going to be used depends on few things such as, indication for each case, experience and knowledge of the clinician and technician and level of equipment of the dental laboratory, as well. Prosthetic materials, such as metal ceramic or modern zirconia showed, through everyday clinical practice and clinical research, as reliable materials that satisfy long-term aesthetic, biomechanics and functional demands of fixed prosthetic restorations supported by dental implants.

Interdisciplinarna suradnja specijalista ortodoncije, oralne kirurgije i doktora dentalne medicine od velike je važnosti prilikom rehabilitacije kompleksnih slučajeva. Prikazan slučaj rješavanja hipodoncije gornjih lateralnih inciziva uz obostranu retenciju gornjih očnjaka naglašava dosege ortodontske i moderne napredne implanto-protetske terapije. U radu su kroz teoretska razmatranja objašnjeni pojmovi hipodoncije i impakcije/retencije zuba, načini dijagnostike, prevalencija i terapijske opcije. Kroz prikaz slučaja prikazane su mogućnosti i primjena kompjuterskog planiranja i prijenos točne pozicije implantata na kliničku situaciju pomoću statičnih vodilica izrađenih 3D printerom. Vodilicama i adekvatnim svrdlima za kompjuterski navođenu kirurgiju moguće je potencijalni rizik ozljeda bitnih anatomskih struktura u čeljusti, prilikom postavljanja dentalnih implantata, svesti na minimum. Također, u radu su pobliže opisane sve vrste kirurških vodilica s prednostima i nedostacima koje one nose prilikom primjene, kao i korištene vrste implantata, nadogradnje na implantatima, materijali definitivnog rada te koji uvjeti trebaju biti zadovoljeni za odluku o imedijatnoj implantaciji. Interdisciplinary cooperation between orthodontics, oral surgery and dentists is of great importance in the rehabilitation of complex cases. The presented case of resolving hypodontia of the upper lateral incisors with bilateral retention of the upper canines emphasizes the achievements of orthodontic and modern advanced implant-prosthetic therapy. The concepts of hypodontia and impaction / retention of teeth, methods of diagnosis, prevalence, and therapeutic options are explained in the paper through theoretical considerations. The case presentation presents the possibilities and application of computer planning and the transfer of the exact position of the implant to the clinical situation using static guides made with a 3D printer. Guides and adequate drills for computer-guided surgery may reduce the potential risk of injury to essential anatomical structures in the jaw when placing dental implants. Also, the paper describes in detail all types of surgical guides with all the advantages and disadvantages that they bring during use, as well as the types of implants used, implant upgrades, materials for definitive work and conditions that should be met in cosidering an immediate implantation.

Computer-aided design/computer-aided manufacturing (CAD/CAM) technology is one of the fastest-growing aspects of modern dentistry, effecting all disciplines of dentistry, especially the fields of prosthodontics and restorative dental medicine. New materials and techniques are being continuously improved. The data about digital technologies and mechanical properties of these materials are scarce. The aim of the first part of the present study was to estimate and collate the mechanical properties of different materials and technologies for denture base manufacturing. The evaluated mechanical properties were flexural strength, surface hardness, and impact strength. The aim of the second part of the present study was to define the shear bond strengths of different denture base resins to different types of prefabricated teeth (acrylic, nanohybrid composite, and cross-linked) and denture teeth produced by CAD/CAM technology (milling). Milled CAD/CAM materials for denture base fabrication showed enhanced mechanical properties when compared to heat-polymerized and 3D printed acrylics. 3D printed acrylics had mechanical properties lower than the majority of other tested denture base resins. Nevertheless, material’s polymerization type cannot guarantee its optimal mechanical properties. When comparing shear bond strengths between denture base materials and prefabricated teeth, heat-polymerized and milled CAD/CAM denture base resins showed higher shear bond strength values compared to the cold-polymerized ones. Cold-polymerized resins should be averted for binding artificial teeth to denture base resins. Denture teeth glued to a milled CAD/CAM denture base resin by using a bonding agent show the same shear bond strength values as the denture teeth adhered to heatpolymerized denture base resins. Svrha rada Napredak i razvoj dentalne medicine očituje se kroz dostupnost i uporabu novih materijala, jednako kao i njihovih novih tehnika obrade. Svrha ovog istraživanja bila je testirati mehanička svojstva materijala za izradu baza potpunih proteza izrađenih različitim tehnologijama, s naglaskom na digitalne tehnologije (computer-aided design/computer-aided manufacturing [CAD/CAM] što uključuje glodanje i trodimenzionalni ispis [3D printing]), te ispitati veznu čvrstoću između različitih vrsta zuba i baze proteze. Materijali i postupci Prvi dio istraživanja testirao je mehanička svojstva (savojna čvrstoća, tvrdoća i žilavost) materijala rabljenih za izradu baze potpunih proteza: tri različita toplopolimerizirajuća akrilata, tri CAD/CAM akrilata (glodanje), 3D printani akrilat te poliamid. Drugi dio istraživanja uspoređivao je veznu čvrstoću između različitih vrsta prefabriciranih zubi (akrilatni, nanohibridno kompozitni i umreženi) i umjetnih zubi dobivenih glodanjem s različitim materijalima za izradu baze potpunih proteza. Drugi dio istraživanja uključio je 10 grupa: hladnopolimerizirajući akrilat i akrilatne zube, hladnopolimerizirajući akrilat i zube od nanohibridnog kompozita, hladnopolimerizirajući akrilat i umrežene zube, toplopolimerizirajući akrilat i akrilatne zube, toplopolimerizirajući akrilat i zube od nanohibridnog kompozita, toplopolimerizirajući akrilat i umrežene zube, CAD/CAM (glodani) akrilat i akrilatne zube, CAD/CAM (glodani) akrilat i zube od nanohibridnog kompozita, CAD/CAM (glodani) akrilat i umrežene zube, CAD/CAM (glodani) akrilat i zube dobivene CAD/CAM obradom (glodanjem). U prvom dijelu istraživanja blokovi toplopolimerizirajućeg akrilata pripremili su se kivetiranjem dok su se blokovi poliamida pripremili postupkom injekcijskog prešanja prema uputama proizvođača. 3D printani uzorci (blokovi) pripremili su se prema STL datoteci u odgovarajućoj jedinici za 3D printanje, uz naknadnu svjetlosnu polimerizaciju u odgovarajućem uređaju prema uputama proizvođača. Svi navedeni uzorci (toplopolimerizirajući, poliamidni, 3D printani i CAD/CAM blokovi za glodanje) obradili su se na stroju za rezanje s vodenim hlađenjem (IsoMet 1000). Sve su se plohe dodatno obrađivale uporabom standardnog metalografskog papira za brušenje (P500, P1000 i P1200) do zadanih dimenzija s glatkim plohama. Savojna čvrstoća mjerila se testom trotočkastog opterećenja uporabom univerzalnog stroja za testiranje (10 uzoraka za svaki testirani materijal dimenzija 64,0 x 10,0 x 3,3 ± 0,2 mm). Prije testiranja uzorci su bili uronjeni u vodenu kupku na 50 ± 1 sati, temperature 37 °C. Deset uzoraka dimenzija 64,0 x 10,0 x 3,3 ± 0,2 mm svakog materijala uporabila su se za testiranje tvrdoće. Sila od 358 N aplicirala se preko kuglice na vrijeme od 60 sekundi. Brinellova tvrdoća mjerila se na pet mjesta na svakom uzorku nakon čega je određena prosječna tvrdoća svakog uzorka. Ispitivanje udarne žilavosti provelo se na Charpyjevom batu. Ispitivanje žilavosti provelo se mjerenjem točnih dimenzija uzorka s odgovarajućim urezanim utorom nakon čega se uzorak stavljao u oslonac, te se na njega s određene visine spustio bat koji je slobodnim padom lomio uzorak. Svaka ispitna skupina imala je 10 uzoraka dimenzija 80,0 x 10,0 x 4,0 ± 0,2 mm. Za drugi dio istraživanja uzorci su pripremljeni na sljedeći način: prefabricirani zubi uronjeni su u bezbojnu hladnopolimerizirajuću smolu u plastičnome kalupu. Nakon polimerizacije uzorci su izvađeni iz plastičnih kalupa. Cervikalna površina prefabriciranog zuba smještenog u bezbojnu smolu izložena je na rezalici s vodenim hlađenjem (IsoMet 1000). Metalni kalup uporabljen je za dobivanje silikonskog uzorka dimenzija 25,0 mm x 2,5 mm. U samom središtu silikonskog uzorka nalazio se kružni otvor dimenzija 5,0 mm x 2,5 mm koji je uporabljen za izradu cilindara. Navedeni silikonski uzorak zalijepio se na izloženu površinu zuba i hladnopolimerizirajuće smole uporabom univerzalnog ljepila. Cilindri toplopolimerizirajućeg akrilata izrađeni su postupkom kivetiranja dok su cilindri hladnopolimerizirajućeg akrilata izrađeni uporabom polimerizatora (Ivomat IP2) pri temperaturi od 40 ℃ i tlaku od 6 bara. Glodalica (Ceramill Mikro 5X) je rabljena za dobivanje CAD/CAM (glodanih) cilindara. CAD/CAM (glodani) cilindri zalijepljeni su adhezivnim sredstvom za CAD/CAM (glodani) materijal za izradu baze potpune proteze. Za testiranje uzoraka upotrijebljen je test smične čvrstoće (Nexygen). Uporabom stereomikroskopa (Olympus SZX10) prijelom je okarakteriziran kao adhezivan, kohezivan ili mješovit. Rezultati Glodani CAD/CAM materijal za izradu baze potpune proteze (IvoBase CAD) i poliamid pokazali su najveće vrijednosti savojne čvrstoće (ni jedan uzorak nije frakturirao tijekom testa trotočkastog opterećenja). U dvije skupine glodanih CAD/CAM materijala utvrđene su najviše vrijednosti tvrdoće (Interdent CC disc PMMA - 145,66 ± 2,22, te Polident CAD/CAM disc basic - 143,82 ± 2,22) dok je treća skupina pokazala najniže vrijednosti tvrdoće (Ivobase CAD - 95,54 ± 9,82), baš kao i poliamid (Vertex ThermoSens - 67,13 ± 10,64). 3D printani materijal (Nextdent Base) pokazao je najniže vrijednosti savojne čvrstoće (71,70 ± 7,38). Medijan test pokazao je značajne statističke razlike između testnih skupina za savojnu čvrstoću i tvrdoću (p < 0,001). Vrijednosti žilavosti iznosile su od 8,01 ± 3,52 kJ/m2 do 44,68 ± 39,37 kJ/m2 . Medijan test pokazao je razlike između materijala prilikom testiranja žilavosti (p < 0,001). Testom smične čvrstoće utvrđene su najniže vrijednosti između hladnopolimerizirajućeg akrilata i svih testiranih vrsta prefabriciranih zubi (akrilatni - 3,37 ± 2,14; nanohibridno kompozitni - 10,14 ± 3,30; umreženi - 10,06 ± 4,35). Između toplopolimerizirajućeg akrilata i CAD/CAM (glodanog) materijala za izradu baze potpune proteze, te testiranih umjetnih zubi nije pronađena značajna razlika (p > 0,05). Zaključak CAD/CAM materijali za izradu baze proteze (glodanje) općenito pokazuju bolja mehanička svojstva u odnosu na toplopolimerizirajuće akrilate i 3D printani akrilat. Unatoč tome, tip polimerizacije materijala ne jamči njegova optimalna mehanička svojstva. Postoje razlike između različitih kombinacija materijala za izradu baze potpune proteze i prefabriciranih zubi. Hladnopolimerizirajući akrilati trebali bi se izbjegavati prilikom pričvršćivanja prefabriciranih zubi u bazu proteze. CAD/CAM (glodanje) i toplopolimerizirajući akrilati za izradu bazu proteze u kombinaciji s prefabriciranim zubima imaju slične vrijednosti prilikom testiranja smične čvrstoće.

U suvremenoj implantoprotetskoj terapiji stope preživljavanja i uspješnost terapije visoke su i gotovo neupitan dio terapije. Glavni je fokus na estetskom ishodu, a zahtjevi pacijenata sve se više povećavaju. Razvoj novih materijala i tehnologija te znanje o parodontnoj i periimplantatnoj biologiji daju nam osnovu za sve bolje estetske rezultate. Kako bi se osiguralo postizanje optimalne estetike, osim pažljivog planiranje terapije suvremenim radiološkim dijagnostičkim metodama, implantati moraju biti postavljeni u optimalnom meziodistalnom, vestubulooralnom i apikokoronarnom smjeru. Također mora biti osiguran i dovoljan volumen kosti u sve tri dimenzije, te udaljenost od susjednih zuba i/ili implantata. Za postizanje adekvatne crveno-bijele estetike važno je uspostaviti ravnotežu između alveolarne kosti, periimplantatne sluznice i fiksnoprotetskog nadomjestka. Svrha rada je prikaz utjecaja pozicije implantata na estetski rezultat u odnosu na kost, stanje mekih tkiva, debljina sluznice i njen stupanj karatinizacije, te veze između implantata i nadogradnje. Nastoje se definirati biološki i mehanički čimbenici koji utječu na krajnji rezultat implantoprotetske terapije. Te koji parametri moraju biti zadovoljeni da se terapija može proglasiti estetski zdovoljavajućom. U radu se analiziraju biološki (PES) i mehanički (WES) parametri koji utječu na ocjenu estetike i time uspješnost implantoloske terapije. Očekivani poželjni rezultat ocjenjuje se analizom fotografije sa minimalno 12 bodova za zadovoljavajuću estetiku do maksimalnih 20 bodova za izvrsnu estetiku na temelju analize fotografije. Parametri su prisutnost ili odsutnost papile, razina i zaobljenost vestibularne sluznice, boja, zaobljenost i tekstura mekih tkiva te nadomjestak koji bojom, oblikom i teksturom i transparencijom odgovara susjednom prirodnom zubu. Doprinos rada je omogućavanje sistematskog pregleda objektivnih parametara koji utječu na estetski rezultat zuba na implantatu kako bi se mogao dobiti numerički, objektivan i ponovljiv rezultat sa odmakom vremena i objektivna ocjena zadovoljavajuće estetike upotrebom različitih kirurških protokola i protetske terapije. In modern implanto prosthetic therapy, survival rates and success of the therapy are high and furthermore they are almost an unquestionable part of the therapy. The main focus has been put on the aesthetic outcome, and moreover patients demands are constantly growing. Development of new materials and technology, as well as knowledge of periodontal and periimplant biology, give us the basics for even better aesthetic results. To insure the achievement of optimal aesthetic, apart from a carefully planned therapy with modern radiological diagnostical methods, implants must be placed in the optimal mesio-distal, vestubulo-oral and apico-coronary direction. In addition, the volume of bone in all three dimensions has to be insured, as well as the distance from neighbor teeth and/or implants, too. To accomplish optimal red and white aesthetic, it is important to achieve harmonious relation between alveolar bone, periimplant mucosa and fixed prostetic restorations. The objective of this paper is to show the impact of the position of the implant on the aesthetic result in relation to bone, the state of soft tissue, the thickness of musosa and its degree of keratinization and the relation of implant and augmentation. The paper ains to define which biological and mechanical factors influence the final result of the implant prosthetic therapy also which parameters have to be fulfilled for the therapy to be proclaimed aesthetically satisfying.Biological (PES) and mechanical (WES) parameters which influence the assessment of aesthetic, including the successfullness of implantal therapy are being analyzed in this paper. The expected desired result of the satisfying aesthetics is evaluated with a minimum of 12 points, to an excellent aesthetic with a maximum of 20 points based on photography analysis. These parameters are the presence or absence of papila, the level and contour of the vestibular mucosa membranes, colour and texture of soft tissue as well as colour appropriate restoration, the shape, texture and transparency of the neighbour natural tooth. The contribution of the paper is to enable a systematic review of objective parameters that affect the aesthetic result of teeth on the implant in order to obtain a numerical, objective and reproducible result over time and an objective assessment of satisfactory aesthetics using different surgical protocols and prosthetic therapy.

Cobalt–chromium alloys (Co-Cr) are widely used in dentistry due to their excellent mechanical properties and corrosion resistance. Since prosthetic materials must be permanently stable in the oral cavity, it is very important to determine the release of ions from alloys in the oral cavity. In dentistry today, metals and alloys are mainly joined by laser and tungsten inert gas (TIG) welding. Therefore, in this work, the release of metal ions from six different Co-Cr alloys joined by these two welding methods was quantified to determine the effects of the welding method on an ion release. Static immersion tests, atomic absorption spectrometry and statistical analysis were performed for this purpose. The results showed that laser-welded alloys release a lower amount of metal ions compared to TIG-welded alloys.

Potpuna bezubost gornje čeljusti često je veliki problem, kako funkcijski tako i estetski. Implantoprotetska sanacija gornje bezube čeljusti omogućuje izradu mobilnog ili fiksnog protetskog rada nošenog implantatima. Odabir implantoprotetskog rada ovisi o stupnju resorpcije alveolarnog nastavka gornje čeljusti, povezano s time gubitku mekih tkiva, međučeljusnim odnosima, željama pacijenta i njegovim mogućnostima, spremnosti na dugotrajnost postupka i dugoročnu suradnju te o pridržavanju uputa o održavanju dobre higijene. Vrlo važan korak u implantoprotetici je informativni razgovor s pacijentom, dobra opća i stomatološka anamneza, rendgenska analiza i procjena psihofizičkog stanja pacijenta. U slučaju većeg gubitka kosti i mekih zubnih tkiva, adekvatno rješenje je izrada mobilne proteze pričvršćene na implantate različitim vrstama spojnih elemenata poput teleskopskih sustava, kugli, lokatora ili prečki. Fiksni protetski rad može biti most pričvršćen vijcima ili cementom na protetske nadogradnje uvijene u minimalno četiri implantata. Od pet prikazanih slučajeva u ovom radu rješavanja bezubosti gornje čeljusti, implantoprotetska rješenja ovisila su o dijagnostici, anatomskim i biološkim mogućnostima i ograničenjima te o željama i financijskim mogućnostima pacijenta. Tri slučaja riješena su fiksnim mostovima pričvršćenim vijcima u četiri ili šest implantata, jedan slučaj mobilnom protezom sa teleskopskim sustavom veze i jedan mobilnom protezom retiniranom prečkom. Također, navedena su različita rješenja i što se tiče gradivnih materijala nadomjestaka: skelet od kobalt-kromove legure obložene akrilatom s akrilatnim ili kompozitnim zubima, skelet od polieter-eter ketona s krunicama od prešane keramike, cirkonijoksidna keramika za patrice teleskopskih krunica kod mobilne proteze od polieter-eter ketona. Complete edentulousness of the upper jaw is a major functional and aesthetical problem. Implant-prosthetic rehabilitation is provided by removable devices or fixed prosthodontics supported by implants. The choice of implant prosthesis depends on the degree of the alveolar process resorption, associated with soft tissue loss, intermaxillary relations, the patient expectations and capabilities, their readiness for a prolonged procedure, a long-term cooperation, and willingness to maintain good hygiene. An important step in implant prosthetics is an informative conversation with the patient, a good general and dental history, X-ray analysis and the patients psychophysical condition. In the case of greater loss of bone and soft tooth tissue, a removable prosthesis should be made attached to the implants with different types of connecting elements; telescopic systems, balls, locators or bars. Fixed prosthetics can be a bridge attached with screws or cement to a minimum of four implants. Of the five cases described, implant prosthetic solutions depended on the diagnosis, anatomical or biological capabilities and limitations and the patients’ wishes and financial capabilities. Three cases were solved with bridges fastened with screws in four or six implants, one case with a removable prosthesis with a telescopic connection system and one with a removable prosthesis with a retained bar. Different solutions are also listed regarding replacement restorative materials: construction base of cobalt-chromium alloy coated with acrylate with acrylate or composite teeth, construction base of polyether ether ketone with crowns of pressed ceramics, zirconium oxide ceramics for telescopic crowns in removable dentures of polyether ether ketone.

Brušenje zuba zahtjevan je i ključan segment fiksnoprotetske terapije. Nužni su pažljiv pristup i dobar plan terapije te poznavanje općih načela brušenja. U suvremenoj protetici fokus je na minimalnoj invazivnosti, no s druge strane brušenjem se mora omogućiti dovoljno mjesta za materijal fiksnoprotetskog rada kako bi se osigurala funkcijska trajnost nadomjeska. Postupak je ireverzibilan, stoga su neophodne detaljna dijagnostika i precizna izvedba. Na brušenje utječu vrsta i materijal budućeg fiksnoprotetskog rada te položaj i broj raspoloživih zuba u zubnome luku. Optimalni instrumentarij za brušenje čine crveni kolječnik i dijamantna svrdla. Velik je oprez potreban prilikom preparacije vratnog dijela zuba kako se ne bi oštetila parodontna tkiva i ugrozila biološka širina. Horizontalna preparacija sa zaobljenom stepenicom zadovoljava uvjete za većinu fiksnoprotetskih radova te je još uvijek preferirana tehnika preparacije. Biološki orijentirana preparacija pripada novijim tehnikama vertikalne preparacije zuba. Omogućava postizanje iznimne estetike, ali je tehnički kompleksnija. Tooth preparation is a demanding and crucial part of fixed prosthodontics. A careful approach, concise treatment plan, and knowledge of the general principles of tooth preparation are necessary. In modern prosthodontics, the focus is on minimal invasiveness, but on the other hand, preparation must allow enough space for the material of the restoration in order not to jeopardize the success of the therapy and its functional longevity. The procedure is irreversible, therefore detailed diagnostics and precise performance are necessary. Type of preparation is influenced by the type and material of future fixed prosthodontic restoration and is defined by the position and number of remaining teeth in the dental arch. The instruments used for tooth preparation are a red micromotor handpiece and diamond burs. Special attention should be paid while preparing the cervical part of the tooth in order not to damage the periodontal tissues and endanger the biological width. Horizontal preparation with a chamfer meets the requirements for most fixed prosthodontic restorations and is still the preferred technique of preparation. Biologically oriented preparation is a newer technique of vertical tooth preparation. It enables the achievement of exceptional aesthetics, but it is technically more complex.

Endodontskom se terapijom, koja uključuje širenje, čišćenje, dezinfekciju i punjenje korijenskih kanala, uz uklanjanje karijesom zahvaćenih tvrdih zubnih struktura, oslabljuje struktura zuba. Cilj postendodontske opskrbe je adekvatna nadoknada tvrdih zubnih tkiva kako bi se umanjio rizik od rubnog propuštanja i fraktura te na taj način sačuvao zub. Prilikom donošenja odluke o planu terapije potrebno je postaviti pravilnu dijagnozu koja uključuje uzimanje anamneze, intra- i ekstraoralni pregled te procjenu periapikalne rendgenske snimke. Ovisno o kvaliteti punjenja ponekad je prije postendodontske opskrbe potrebno napraviti reviziju punjenja. Manji krunski defekti uspješno se nadoknađuju kompozitnim ili staklenoionomernim materijalima, dok su kod većih gubitaka indicirani indirektni nadomjesci i prema potrebi intrakanalne nadogradnje. Inlayi, onlayi i overlayi se izrađuju izvan pacijentovih usta, a razlikuju se po plohama i broju kvržica koje prekrivaju. Za njihovu se izradu koriste keramički i kompozitni materijali. Dvije su velike skupine nadogradnji: individualne i konfekcijske. Najčešće se primjenjuju intrakanalni kolčići ojačani staklenim vlaknima radi dobrih mehaničkih svojstava sličnih dentinu, ali i zato što osiguravaju retenciju budućeg nadomjeska, krunice ili mosta. Kod velikih krunskih defekata indicirano je zub opskrbiti krunicom. Glavni ciljevi postendodontske opskrbe i adekvatnog endodontskog liječenja su onemogućiti prodor mikroorganizama, rekonstruirati izgubljena tvrda zubna tkiva te zadovoljiti estetske zahtjeve pacijenta. Na uspješnost terapije utječe pravilno postavljanje dijagnoze, poštovanje svih koraka tijekom provođenja terapije, suradnja s pacijentom i njegova briga o oralnoj higijeni. Endodontic therapy, which includes spreading, cleaning, disinfection, and filling root canals, while eliminating the hard dental tissue affected by caries, weakens the tooth's structure. The aim of post-endodontic therapy is adequate compensation for hard dental tissues in order to reduce the risk of marginal leakage and fractures, thereby preserving the tooth. When deciding on a therapy plan, it is necessary to make a correct diagnosis which includes taking an anamnesis, intra- and extraoral examination, and evaluation of the periapical X-ray. Depending on the filling quality, it is sometimes necessary to make the revision of the filling before postendodontic therapy. Smaller crown defects are successfully compensated by composite or glass ionomer materials, while indirect restorations and, if necessary, intracanal restorations are indicated for bigger dental tissue losses. Inlays, onlays and overlays are made outside the patient's mouth, and differ from each other by the surfaces and number of cusps they cover. They are made out of ceramic and composite materials. There are two large groups of post and core: individual and confectionary. The most commonly used intracanal restorations are posts reinforced by glass fibers because of their of good mechanical properties similar to dentine, but also because they ensure the retention of the future restoration, crown or bridge. In case of the large crown defects it is indicated to restore a tooth with the crown. The main objectives of post-endodontic therapy and adequate endodontic treatment are to prevent the penetration of microorganisms, to reconstruct lost hard dental tissues and to meet the patient's aesthetic requirements. The success of therapy is influenced by proper diagnosis, respect for all steps during the therapy, collaboration with the patient and his or her care of oral hygiene.

Cilj ovog istraživanja bio je utvrditi razliku u percepciji anatomskih varijacija prednjih zuba i okolnih struktura s obzirom na stupanj edukacije procjenjivača, a u tu su skupinu uključeni opća populacija, opći doktori dentalne medicine, specijalisti ortodoncije, specijalisti protetike i specijalisti parodontologije. U prvom dijelu istraživanja nastojali smo utvrditi postoji li statistički značajna razlika u procjeni anatomskih varijacija zuba s obzirom na stupanj edukacije, dob i spol procjenjivača. Isto tako nastojali smo utvrditi koliko vrsta specijalizacije, dob i spol pojedinačno i zajedno utječu na procjenu prilikom ispunjavanja OES upitnika (Orofacijalna estetska skala). Drugi dio istraživanja sastoji se od analize i procjene kompjuterski manipuliranih fotografija osmijeha i donje trećine lica te koliki raspon varijacija svjetline zuba sve navedene skupine procjenjivača prihvaćaju i kada su zapazili da je promjena uočljiva te do koje granice smatraju da je ta promjena prihvatljiva. Na ostalim manipuliranim fotografijama se osim boje zuba procjenjivala varijacija svjetline zubnog mesa oko zuba i do koje granice procjenjivači smatraju fotografiju prihvatljivom. Dalje se također procjenjivao raspon varijacije položaja rotacije zuba i kada su procjenjivači zapazili da je promjena uočljiva i do koje granice smatraju da je fotografija prihvatljiva. Rezultati ovog istraživanja su pokazali da su sva veća odstupanja od idealne estetike bila ocjenjena lošijim ocjenama od strane procjenjivača. Specijalisti parodontologije su dali najniže ocjene te su najkritičnija skupina među doktorima dentalne medicine i kritičniji su od opće populacije. Specijalisti protetike su generalno manje kritični i više tolerantni na promjene estetike donje trećine lica što se može objasniti njihovim velikim znanjem i iskustvom o kompleksnosti postizanja idealne estetike. Opća populacija je najlošije zapažala promjene u boji zuba i zubnog mesa te rotaciji zuba, što pokazuje koliko je edukacija doktora dentalne medicine važna za njihov klinički rad i sposobnost zapažanja. Specijalisti protetike i specijalisti parodontologije su prvi zapazili promjene boje zuba i promjene zubnog mesa. Specijalisti ortodoncije su kao i opći doktori dentalne medicine i opća populacija srednje kritični naspram estetike osmijeha. Specijalisti ortodoncije su tek nakon specijalista protetike i parodontologije što se tiče zapažanja promjene u položaju zuba i bili su najkritičniji po tom pitanju narušavanja estetike donje trećine lica. Introduction: The traditional focus of stomatology was, in the past, based mainly on biology and the aspects of its functions, but the modern approach is increasingly being directed towards patients and aesthetics, which nowadays is considered an important and integral part of a patient's oral hygiene. Therefore, nowadays when we discuss the improvement of quality of an individual's life we refer to removing oral pain and problems linked to chewing and speaking as well as improving their aesthetics. Thus, dental practitioners should not only pay attention to oral problems, but also consider the patient in general and evaluate how the entirety of the therapy in oral cavity will affect their overall health and quality of life. Aim: The aim of this research is to determine the difference in perception of anatomical variations of front teeth and surrounding structures considering the evaluator's degree of education, and the group includes: general population, general dental practitioners, orthodontic specialists, prosthetics specialists and periodontology specialists. Participants and Methods: The research consists of two parts: the first part of the research consisted of evaluating the photographs of multiple examinees (60 examinee photographs were chosen), and the second part consisted of evaluating manipulated photographs of a sole examinee, that is the photograph that frequently stands out as a typical example, was chosen for the second part of the research. During the first part of the research we attempted to determine whether there was a statistically significant difference in the evaluation of anatomical variations of teeth based on the examinee's age and gender. We also attempted to determine how many types of specialisations, age and gender individually and collectively affected the evaluation during the process of filling out the OES questionnaire. At the end of the first part of the research we compared its results with similar studies that were also conducted by using the standardized OES questionnaire. The second part of the research comprises the analysis and the evaluation of technologically manipulated photographs of smiles and the lower third of the face, and the range of variations of teeth brightness that all groups of evaluators accept as well as the point when they noticed that the change was apparent and to which extent do they consider it to be acceptable. Other manipulated photographs were used to evaluate, apart from the colour of the teeth, the variation of brightness of gums around the teeth and to which extent the evaluators considered the photograph to be acceptable. Later the evaluation included variations of positions of the teeth rotation and the point when evaluators noticed that the change was noticeable and to which extent they considered the photograph to be acceptable. Research results have shown that all major deviations from the ideal aesthetics were given lower marks from the evaluators. Results: Specialists od periodontology gave the lowest marks, and were the most critical group among dental practitioners and were proven to be more critical than the general population. Specialists of prosthetics were generally less critical and more tolerant to aesthetic changes to the lower third of the face which can be explained thanks to their great knowledge and experience of the complexities of achieving ideal aesthetics. The general population was the least successful at noticing changes to the color of the teeth and gums as well as the rotation of the teeth, which demonstrates the importance of education for dental practitioners, their clinical work and their perceptive abilities. Specialists of prosthodontics and periodontology were the first ones to notice the change in teeth and gum colour. Orthodontists, much like general dental practitioners and the general population are moderately critical of smile aesthetics. Orthodontists place second after prosthodontists and periodontologists in noticing changes to the position of teeth and were the most critical regarding the disruption of aesthetics to the lower third of the face. The evaluators' age did not significantly affect their mark for aesthetic teeth shape and colour, the appearance of dental arches and lips, and the evaluation of gingiva and the overall appearance of the lower third of the face. However, the research has proven that women were more critical than men when evaluating the appearance of the mouth and gums, and that they focused on these two characteristics of the smile. Conclusion: Based on the results of this research we can conclude the following: all evaluating groups gave worse marks to each deviation from the ideal aesthetics and were increasingly more critical as the deviation strayed further from the ideal. Specialists of periodontology gave the lowest marks, which means that they were the most critical group of dental practitioners and are more critical in comparison to the general population. Despite the fact that specialists of prosthodontics are better at noticing changes than the general population and most dental practitioners, they are generally less critical and more tolerant of aesthetic changes to the lower third of the face, which can be explained thanks to their great knowledge of the complexity of achieving the ideal aesthetics. General population was the worst at noticing teeth and gingiva colour and teeth rotation, which demonstrates the importance of education for dental practitioners, their clinical work and their perceptive abilities. It was expected that specialists of prosthodontics to be the first ones to notice changes to the teeth colour, and specialists of periodontology to be the first ones to notice changes to the colour of gingiva, which was partially proved to be correct because both groups of specialists evaluated both of these changes almost equally. Orthodontic specialists were similar to general dental practitioners and the general population based on their evaluations, which proved them to be moderately critical of smile aesthetics. It was expected of them to be the first ones to notice changes in the rotation of teeth, while prosthodontists and periodontologists were unexpectedly the first ones to notice changes in the position of the teeth and were the most critical in regards to it disrupting the aesthetics of the lower third of the face. The biggest differences between dental practitioners in regards to aesthetics of the lower third of the face were between specialists of prosthodontics and periodontology, whilst orthodontists and general dental practitioners fell in the middle in regards to the criticism of the appearance of the mouth, dental arches, tooth shape and gums, meanwhile all dental practitioners were equally critical of teeth colour. Prosthodontists and periodontologists displayed minor differences in their observational capabilities and were equally critical of the changes in teeth and gingiva colour and teeth rotation. The evaluators' age had no effect during the evaluation of aesthetics of the shape and color of the teeth, appearance of dental arches and lips, nor the evaluation of gingiva and the overall appearance of the lower third of the face. It was proved that women were more critical than men only in regards to evaluating the appearance of the mouth and gums, i.e. in comparison to men they tend to focus more on these two characteristics of the smile. The stated results may help dental practitioners in planning therapies and additional education for specific specialists. It is necessary to additionally increase the number of evaluators in order to define the effect of their age on the evaluation process, as well as other aesthetic factors that are important to dental practitioners and their assessment of aesthetics of the lower third of the face.

Background: This randomized trial’s objective was to investigate the impact of social network content on the perception of smiles among specialists, doctors, students of dental medicine, and laypeople. Method: A sample of 360 respondents was shown 7 digitally altered photographs of smiles (85.63% female, 14.37% male). Dental specialists, dentists, dental students (first to third year and fourth to sixth year), and laypeople made up the sample. Respondents were asked to rank the images on a scale of 1 to 10, starting with the least appealing and moving up to the most attractive, using a Google Form. Respondents were divided into experimental and control groups at the end of the following month by random selection. The experimental group followed an Instagram profile posting two images of beautiful smiles for seven days, while the control group received no intervention at all. Both groups then completed the same questionnaire again. The comparison of esthetic scores between the experimental and control group was performed using the Mann–Whitney U-test and the difference in test responses between the starting point of the measurement and after exposure to perfect content on social media within individual groups was tested with the Wilcoxon paired-samples test. When comparing the absolute difference of scores, the Mann–Whitney U-test and the Kruskal–Wallis test were used. Results: Respondents in the experimental group rated the rounded embrasures of the incisors with lower esthetic scores compared to the control group that was not exposed to images on the Instagram social network. In those exposed to Instagram (experimental group), laypeople showed significantly greater satisfaction with their own smile after the exposure to Instagram, whereas no such difference was present in the control group. Conclusions: The content of social networks potentially has an influence on smile perception, most visible in the perception of incisal embrasures and self-perception of smile.